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The effect of antibiotic stewardship interventions with stakeholder involvement in hospital settings: A multicentre, cluster randomized controlled intervention study
- Source :
- Antimicrobial Resistance and Infection Control, Vol 7, Iss 1, Pp 1-12 (2018), Antimicrobial Resistance and Infection Control, 7:109
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- Background: There is limited evidence from multicenter, randomized controlled studies to inform planning and implementation of antibiotic stewardship interventions in hospitals. Methods: A cluster randomized, controlled, intervention study was performed in selected specialities (infectious diseases, pulmonary medicine and gastroenterology) at three emergency care hospitals in Western Norway. Interventions applied were audit with feedback and academic detailing. Implementation strategies included co-design of interventions with stakeholders in local intervention teams and prescribers setting local targets for change in antibiotic prescribing behaviour. Primary outcome measures were adherence to national guidelines, use of broad-spectrum antibiotics and change in locally defined targets of change in prescribing behaviour. Secondary outcome measures were length of stay, 30-day readmission, in-hospital- and 30-day mortality. Results: One thousand eight hundred two patients receiving antibiotic treatment were included. Adherence to guidelines had an absolute increase from 60 to 66% for all intervention wards (p = 0.04). Effects differed across specialties and pulmonary intervention wards achieved a 14% absolute increase in adherence (p = 0.003), while no change was observed for other specialties. A pulmonary ward targeting increased use of penicillin G 2 mill IU × 4 for pneumonia and COPD exacerbations had an intended increase of 30% for this prescribing behaviour (p
- Subjects :
- 0301 basic medicine
Psychological intervention
GUIDELINES
Academic detailing
Antimicrobial Stewardship
VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Infeksjonsmedisin: 776
0302 clinical medicine
Medical microbiology
Outcome Assessment, Health Care
Pharmacology (medical)
030212 general & internal medicine
Public, Environmental & Occupational Health
Antibiotic stewardship
Cross Infection
COPD
Norway
Hospitals
TIME
Anti-Bacterial Agents
Infectious Diseases
INFECTIONS
Guideline Adherence
Life Sciences & Biomedicine
Microbiology (medical)
medicine.medical_specialty
030106 microbiology
Intervention
cRCT
Context (language use)
Audit
Disease cluster
Microbiology
lcsh:Infectious and parasitic diseases
Hospital
03 medical and health sciences
Audit with feedback
Goal setting
Intervention (counseling)
medicine
Humans
lcsh:RC109-216
Science & Technology
business.industry
Research
Health Plan Implementation
Public Health, Environmental and Occupational Health
CONSUMPTION
medicine.disease
Emergency medicine
business
RESISTANCE
Bergen Intervention Teams
Subjects
Details
- ISSN :
- 20472994
- Volume :
- 7
- Database :
- OpenAIRE
- Journal :
- Antimicrobial Resistance & Infection Control
- Accession number :
- edsair.doi.dedup.....3e06cbc662d530476f9d85346d2a92d8