Clinical impact of monitoring frequency per day as a prospective audit and feedback strategy for patients receiving antimicrobial agents by injection

Goto-Fujibayashi, Ayasa; Niwa, Takashi; Yonetamari, Jun; Ito-Takeichi, Syuri; Suzuki, Keiko; Ohta, Hiroyuki; Niwa, Ayumi; Tsuchiya, Mayumi; Ito, Yukiko; Hatakeyama, Daijiro; Hayashi, Hideki; Sugiyama, Tadashi; Baba, Hisashi; Suzuki, Akio; Murakami, Nobuo

doi:10.1111/ijcp.14785

Cited by 1 publication

(1 citation statement)

References 25 publications

(54 reference statements)

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“…Overall, the audit and feedback process proved to be time-consuming, as is also seen by others. 11 , 26 , 27 We required approximately 30 minutes for each case audit, including preparation time. Because our study revealed a reduction in antimicrobial use only in audited patients, a larger time investment would be needed to achieve a hospital-wide improvement in antimicrobial use through audit and feedback, either by conducting more face-to-face audits or by conducting a case-audit for every admitted patient using antimicrobials.…”

Section: Discussionmentioning

confidence: 99%

Positive effects of audit and feedback on antimicrobial use in hospitalized patients limited to audited patients

Engel-Dettmers,

Al Naiemi,

Dijkema

et al. 2024

ASHE

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Objective: Audit and feedback is an antimicrobial stewardship (AMS) strategy, with the potential to also optimize antimicrobial use in non-audited patients. This study aimed to determine whether audit and feedback reduce antimicrobial use in both audited and non-audited patients. Design: Before-after trial with a 1-year intervention period and 2.5-year historical cohort. Setting: 750-bed community hospital in the Netherlands. Patients: All patients admitted to the urology wards during the 3.5-year study period were observed. Patients were classified as using antimicrobials if any antimicrobial was used for therapeutic reasons. Patients using antimicrobials prophylactically were excluded from measurements. Intervention: The AMS team provided audit and feedback on antimicrobial use for patients using antimicrobials for 2 days. Retrospectively, antimicrobial use and length of stay (LOS) were compared with the historical cohort. Results: Audits modified antimicrobial treatment in 52.8% of the cases. De-escalating, stopping, and switching from intravenous to oral treatment accounted for 72% of these modifications. Compared to patients from the cohort, who also used antimicrobials for 2 days, antimicrobial use decreased from 14.21 DDD/patient (95% CI, 13.08–15.34) to 11.45 DDD/patient (95% CI, 8.26–14.64; P = .047) for audited patients. Furthermore, mean LOS decreased from 7.42 days (95% CI, 6.79–8.06) to 6.13 days (95% CI, 5.38–6.89; P = .031). However, looking at all patients admitted to the urology wards, the percentage of patients using antimicrobials and total antimicrobial use remained unchanged. Conclusions: Audit and feedback reduce antimicrobial use and LOS, but only for audited patients. Positive effects are not automatically transferred to patients for whom no audits have been performed.

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Section: Discussionmentioning

confidence: 99%