Audit and Feedback Processes Among Antimicrobial Stewardship Programs: A Survey of the Society for Healthcare Epidemiology of America Research Network

Abstract

Optimal implementation of audit-and-feedback is an important part of advancing antimicrobial stewardship programs. Our survey demonstrated variability in how 61 programs approach audit-and-feedback. The median (interquartile range) number of recommendations per week was 9 (5-19) per 100 hospital-beds. A major perceived barrier to more comprehensive stewardship was lack of resources. Infect Control Hosp Epidemiol 2016;37:704-706.

Outcomes Associated With Antimicrobial De-escalation of Treatment for Pneumonia Within the Veterans Healthcare Administration

“…Facilitation of de-escalation occurs through several resource-intensive activities including prospective audit and feedback, intravenous to oral switch, and antibiotic time-outs [1]. A SHEA research network survey of 61 inpatient ASPs reported a median of 9 interventions per 100 hospital beds per week, suggesting that only a fraction of eligible patients on antimicrobial therapy receive audit and feedback, including de-escalation, due to high workload burden [4]. …”

Time Efficiency Assessment of Antimicrobial Stewardship Strategies

“…Some of these patients may have met criteria for HBV treatment prior to the initiation of HCV therapy. In the case series reported by Bersoff-Matcha and colleagues from the US Food and Drug Administration, the status of HBV infection was incomplete for many patients, which limits the interpretation of the risk of HBV flare, particularly among those reported to be HBsAg negative [3]. Liu and colleagues presented data in 2016 on HBV reactivation in 134 patients receiving DAA treatment for HCV [4].…”

“…PPRF can take many forms but is invariably both human resource and time intensive. Many hospitals may lack the resources to initiate this level of stewardship universally [3,4], and there is therefore a need to identify the form of PPRF that most efficiently impacts inappropriate antimicrobial prescribing [5,6]. We performed a prospective, observational study that compared different forms of PPRF: ward round reviews on acute medical wards, ward round reviews on surgical recovery wards, and telephone reviews with clinical teams caring for patients receiving carbapenems, cephalosporines, or quinolones.…”

Barriers and Facilitators to Implementation of Antibiotic Stewardship Programmes in Hospitals in Developed Countries: Insights From Transnational Studies

“…Reasons for exclusion were: no full-text (n = 1), no original data (n = 11), not transnational (n = 15), study setting (n = 3), type of participants (n = 4), not an ASP (Charani et al, 2011), barriers or facilitators unreported (n = 18). Eight studies met the criteria and were included in this review (Itokazu et al, 2006;Johannsson et al, 2011;Howard et al, 2015;Bryant, 2015;Fleming et al, 2015;Livorsi et al, 2016;Wolf et al, 2016;.…”