Exploring Antimicrobial Stewardship Influential Interventions on Improving Antibiotic Utilization in Outpatient and Inpatient Settings: A Systematic Review and Meta-Analysis

Exploring Antimicrobial Stewardship Influential Interventions on Improving Antibiotic Utilization in Outpatient and Inpatient Settings: A Systematic Review and Meta-Analysis

Antimicrobial stewardship interventions are targeted efforts by healthcare organizations to optimize antimicrobial use in clinical practice. The study aimed to explore effective interventions in improving antimicrobial use in hospitals. Literature was systemically searched for interventional studies...

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Bibliographic Details
Published in:Antibiotics (Basel) Vol. 11; no. 10; p. 1306
Main Authors: Sadeq, Ahmed A, Hasan, Syed Shahzad, AbouKhater, Noha, Conway, Barbara R, Abdelsalam, Abeer E, Shamseddine, Jinan M, Babiker, Zahir Osman Eltahir, Nsutebu, Emmanuel Fru, Bond, Stuart E, Aldeyab, Mamoon A
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 26-09-2022
MDPI
Subjects:
Algorithms
Analysis
Antibiotics
Antiinfectives and antibacterials
Antimicrobial agents
antimicrobial stewardship
antimicrobial use
Audits
Clinical decision making
clinical practice
Clinical trials
Feedback
Intervention
interventions
Length of stay
Meta-analysis
Mortality
multidisciplinary team
Multidisciplinary teams
Pharmacists
Review
Systematic review
clinical practice
interventions
multidisciplinary team
antimicrobial use
antimicrobial stewardship
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Summary:Antimicrobial stewardship interventions are targeted efforts by healthcare organizations to optimize antimicrobial use in clinical practice. The study aimed to explore effective interventions in improving antimicrobial use in hospitals. Literature was systemically searched for interventional studies through PubMed, CINAHL, and Scopus databases that were published in the period between January 2010 to April 2022. A random-effects model was used to pool and evaluate data from eligible studies that reported antimicrobial stewardship (AMS) interventions in outpatient and inpatient settings. Pooled estimates presented as proportions and standardized mean differences. Forty-eight articles were included in this review: 32 in inpatient and 16 in outpatient settings. Seventeen interventions have been identified, and eight outcomes have been targeted. AMS interventions improved clinical, microbiological, and cost outcomes in most studies. When comparing non-intervention with intervention groups using meta-analysis, there was an insignificant reduction in length of stay (MD: -0.99; 95% CI: -2.38, 0.39) and a significant reduction in antibiotics' days of therapy (MD: -2.73; 95% CI: -3.92, -1.54). There were noticeable reductions in readmissions, mortality rates, and antibiotic prescriptions post antimicrobial stewardship multi-disciplinary team (AMS-MDT) interventions. Studies that involved a pharmacist as part of the AMS-MDT showed more significant improvement in measured outcomes than the studies that did not involve a pharmacist.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:2079-6382
2079-6382
DOI:10.3390/antibiotics11101306