Interventions to improve antibiotic prescribing practices for hospital inpatients

Davey, Peter; Marwick, Charis; Scott, Claire; Charani, Esmita; McNeil, Kirsty; Brown, Erwin; Gould, Ian M.; Ramsay, Craig; Michie, Susan

doi:10.1002/14651858.cd003543.pub4

Cited by 838 publications

(1,166 citation statements)

References 280 publications

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“…In this study, antibiotic restriction and later removal of the restriction have been investigated to determine what kind of behavior it causes in physicians who prescribe antibiotics (19). The study consisted of three periods.…”

Section: Discussionmentioning

confidence: 99%

Positive e ect of restrictions on antibiotic consumption

2018

Turk J Med Sci

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Background/aim: This study aimed to examine the change in the etiology of hospital infections with restricting and releasing of group 2 carbapenems (G2C) (meropenem/imipenem/doripenem). Materials and methods:This study was planned in three periods. Study period 1 (SP-1): Carbapenems were prescribed without restriction by infectious disease specialists. SP-2: G2C prescription was restricted. SP-3: Carbapenem prescription was released.

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Section: Discussionmentioning

confidence: 99%

Positive e ect of restrictions on antibiotic consumption

2018

Turk J Med Sci

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“…Up to 50% of antibiotic usage is either unnecessary or inappropriate. 66 Rates of antibiotic use correlate with increased rates of HAI, including CDI, and patients receiving any antibiotics are more receptive to MRO colonisation. The judicious use of antibiotics is the most modifiable factor in combating antibiotic resistance; AMS strategies must ensure the correct antibiotic is prescribed at the right time for the right diagnosis.…”

Section: The Bundles Of Carementioning

confidence: 99%

Healthcare‐acquired infections: prevention strategies

Fernando

Gray

Gottlieb

2017

Internal Medicine Journal

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Healthcare‐acquired infections (HAI) impact on patient care and have cost implications for the Australian healthcare system. The management of HAI is exacerbated by rising rates of antimicrobial resistance (AMR). Health‐care workers and a contaminated hospital environment are increasingly implicated in the transmission and persistence of multi‐resistant organisms (MRO), as well as other pathogens, such as Clostridium difficile. This has resulted in a timely focus on a range of HAI prevention actions. Core components include antimicrobial stewardship, to reduce overuse and ensure evidence‐based antimicrobial use; infection prevention strategies, to control MRO – particularly methicillin‐resistant Staphylococcus aureus (MRSA), vancomycin‐resistant Enterococcus spp. (VRE) and, more recently, multi‐resistant Gram‐negative bacteria; enhanced institutional investment in hand hygiene; hospital cleaning and disinfection; and the development of prescribing guidelines and standards of care. AMR surveillance and comparisons of prescribing are useful feedback activities once effectively communicated to end users. Successful implementation of these strategies requires cultural shifts at local hospital level and, to tackle the serious threat posed by AMR, greater co‐ordination at a national level. HAI prevention needs to be multi‐modal, requires broad healthcare collaboration, and the strong support and accountability of all medical staff.

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“…Advocating these methods in resourceconstrained settings with limited regulatory capacity is problematic and not without the significant risk of compromising expenditure on other critical aspects of healthcare delivery. 28 While there is some evidence of the effectiveness of responsible use policies aimed at curbing excess use in publicly funded healthcare systems, evidence from private sector is notably lacking. 29 In areas of the world such as South Asia, where 80% of patients seek care in the private healthcare system, evaluating policies to regulate or modulate antimicrobial use is urgently needed.…”

Section: Responsible Use By Healthcare Workersmentioning

confidence: 99%