geoffrey modest medical blogs

  an effective and generalizable/scalable antibiotic stewardship program has been developed by the Agency for Healthcare Research and Quality Safety Program for decreasing antibiotic usage (see   antibiotic stewardship program jama2021  in dropbox, or doi:10.1001/jamanetworkopen.2021.0235).   Details: --437 hospitals enrolled in the program, with 402 (92%) remaining in the program for the full year     --28 academic medical center, 122 midlevel teaching hospitals, 167 community hospitals, and 85 critical access hospitals     -- 43% of the hospitals did not have access to infectious disease (ID) specialists --intervention: all clinical staff (clinicians, pharmacists, nurses) were encouraged to participate in 17 webinars over 12 months on antibiotic prescribing, along with some additional durable educational content (commitment posters, computer desktop backgrounds, pocket cards). topics of the webinars included antibiotic stewardship programs,...

A recent systematic review and meta-analysis found that hospital antibiotic stewardship programs significantly reduced the incidence of infections and colonization with antibiotic- resistant  bacteria and C difficile infections (see  antibiotic resistance  dec  with stewardship lancetID2017  in  dropbox , or doi.org/10.1016/ S1473-3099(17)30344-4). Details: --32 studies  in a meta -analysis with 9,056,241 in-hospital patient days and 159 estimates of incidence ratios (IRs) of target infections --studies from 20 countries: US (5 studies), Japan (4), Germany (3), France (3). Most common design was before-after analyses --most frequent  stewardship   interventions:  audits in 59%, implementation of restrictive policies in 47%, co-implementation of stewardship programs with infection control measures (mostly hand hygiene) in 25% Results: --antibiotic stewardship programs  reduced  the ...