A Handshake From Antimicrobial Stewardship Opens Doors for Infectious Disease Consultations

Messacar, Kevin; Campbell, Kristen; Pearce, Kelly; Pyle, Laura; Hurst, Amanda L.; Child, Jason; Parker, Sarah K.

doi:10.1093/cid/cix139

Cited by 30 publications

(26 citation statements)

References 12 publications

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“…In this study, the annual number of consultations increased rapidly from 211 in 2010 to 1255 in 2016, as the number of fellow physicians increased. Consultation does impact the management of infectious diseases and should have a synergistic effect on antimicrobial use (Butt et al, 2015;Messacar et al, 2017). Although restrictions on physician autonomy were introduced, no backlash from the prescribing physicians was experienced.…”

Section: Discussionmentioning

confidence: 99%

Sustained pediatric antimicrobial stewardship program with consultation to infectious diseases reduced carbapenem resistance and infection-related mortality

Horikoshi

Suwa

Handa

et al. 2017

International Journal of Infectious Diseases

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Section: Discussionmentioning

confidence: 99%

Sustained pediatric antimicrobial stewardship program with consultation to infectious diseases reduced carbapenem resistance and infection-related mortality

Horikoshi

Suwa

Handa

et al. 2017

International Journal of Infectious Diseases

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“…A recent study observed that despite the introduction of an AMS program, there was no reduction in the number of Infectious Diseases consultations, and on the contrary, the authors saw a rise in consultations after AMS implementation. 13 Whether corridor advice or curbside consultation made any impact on this particular question in our survey remains uncertain. Certainly more informal Infectious Diseases consultations have been received on AMS rounds as the consultants are easily accessible on the wards to discuss patients while doing AMS rounds.…”

Section: Discussionmentioning

confidence: 89%

Changes in Antimicrobial Prescribing Behavior after the Introduction of the Antimicrobial Stewardship Program: A Pre- and Post-Intervention Survey

Chavada

Walker

Tong

et al. 2017

Infectious Disease Reports

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The introduction of an antimicrobial stewardship (AMS) program is associated with a change in antimicrobial prescribing behavior. A proposed mechanism for this change is by impacting the prescribing etiquette described in qualitative studies. This study sought to detect a change in prescribing attitudes 12 months after the introduction of AMS and gauge utility of various AMS interventions. Surveys were distributed to doctors in two regional Australian hospitals on a convenience basis 6 months before, and 12 months after, the introduction of AMS. Agreement with 20 statements describing attitudes (cultural, behavioral and knowledge) towards antimicrobial prescribing was assessed on a 4-point Likert scale. Mean response scores were compared using the Wilcoxon Rank sum test. 155 responses were collected before the introduction of AMS, and 144 afterwards. After the introduction of AMS, an increase was observed in knowledge about available resources such as electronic decision support systems (EDSS) and therapeutic guidelines, with raised awareness about the support available through AMS rounds and the process to be followed when prescribing restricted antimicrobials. Additionally, doctors were less likely to rely on pharmacy to ascertain when an antimicrobial was restricted, depend on infectious diseases consultant advice and use past experience to guide antimicrobial prescribing. Responses to this survey indicate that positive changes to the antimicrobial prescribing etiquette may be achieved with the introduction of an AMS program. Use of EDSS and other resources such as evidence-based guidelines are perceived to be important to drive rational antimicrobial prescribing within AMS programs.

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“…26 Direct, face-to-face interactions such as "handshake stewardship" is always favored when possible, because they foster a collaborative relationship between the stewardship team and clinicians, but they can be labor intensive. 27 Although telephone calls or notes in the medical record will never be substitutes for human interactions, they can play an important role in promoting evidence-based antibiotic use and may be more feasible for many programs. Stewardship programs may want to consider prior approval, postprescription review with feedback, or a combination of the 2 approaches to encourage judicious antibiotic use.…”

Section: Prior Approval Versus Postprescription Review With Feedbackmentioning

confidence: 99%

Antibiotic Stewardship in Pediatrics

2021

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Antibiotic overuse contributes to antibiotic resistance, which is a threat to public health. Antibiotic stewardship is a practice dedicated to prescribing antibiotics only when necessary and, when antibiotics are considered necessary, promoting use of the appropriate agent(s), dose, duration, and route of therapy to optimize clinical outcomes while minimizing the unintended consequences of antibiotic use. Because there are differences in common infectious conditions, drug-specific considerations, and the evidence surrounding treatment recommendations (eg, first-line therapy, duration of therapy) between children and adults, this statement provides specific guidance for the pediatric population. This policy statement discusses the rationale for inpatient and outpatient antibiotic stewardship programs; essential personnel, infrastructure, and activities required; approaches to evaluating their effectiveness; and gaps in knowledge that require further investigation. Key guidance for both inpatient and outpatient antibiotic stewardship programs are provided.

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A Handshake From Antimicrobial Stewardship Opens Doors for Infectious Disease Consultations

Cited by 30 publications

References 12 publications

Sustained pediatric antimicrobial stewardship program with consultation to infectious diseases reduced carbapenem resistance and infection-related mortality

Sustained pediatric antimicrobial stewardship program with consultation to infectious diseases reduced carbapenem resistance and infection-related mortality

Changes in Antimicrobial Prescribing Behavior after the Introduction of the Antimicrobial Stewardship Program: A Pre- and Post-Intervention Survey

Antibiotic Stewardship in Pediatrics

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