A loose definition of antibiotic stewardship encompassing interventions to alter antibiotic prescribing patterns in nursing homes, including decisions to initiate antibiotic therapy, as well as the choice and duration of therapy, was employed in the development of this review.
The findings of the study will be analysed using the TDF and BCT taxonomy to identify key areas to target in antimicrobial stewardship interventions.
In order to develop effective stewardship interventions, there is a need for additional data on current patterns of inappropriate fluoroquinolone prescribing among hospitalized patients.
Compared with forecasted consumption, reduction in the use of these antibiotics following the '4C' antibiotic stewardship intervention was projected to have reduced prevalence density of MRSA bacteraemia by 0.027 (0.15 to 0.039)/1000 AOBDs.
The application of the findings to the COM-B model and the BCT taxonomy has provided suggestions for appropriate intervention functions on which to model future antimicrobial stewardship interventions.
Many antibiotic stewardship interventions are not well-enough grounded in theory to understand why they succeed or fail.
There is also a need for more research on how to implement both types of stewardship interventions with fidelity and sustain them over time, particularly in nursing homes with limited quality improvement resources.
Libby Dodds-Ashley talks about the 2-day Antimicrobial Stewardship Research Workshop, hosted by the Society for Healthcare Epidemiology of America (SHEA), and how it brings together physicians, pharmacists, and other health professionals to learn how to study and assess the performance of antibiotic stewardship interventions.
Stewardship interventions focused on specific diagnoses and antimicrobials are unlikely to result in programmatic success unless these factors are also addressed.Infect Control Hosp Epidemiol 2018 1-8.
Since physicians play an important role in antibiotic usage, it is vital to understand their antibiotic-prescribing behaviour and knowledge on antimicrobial resistance in order to develop and implement effective antibiotic stewardship interventions.
