Antibiotic stewardship using audit, feedback safe in ICU settings

A study, published in Clinical Infectious Diseases, examined antimicrobial stewardship programs using audit and feedback in the intensive care unit setting.

Researchers conducted a systematic review and meta-analysis of audit and feedback in the ICU setting using 2,447 citations and 11 studies.

Five studies directed audit and feedback at all or most ICU patients on antibiotics and measured overall ICU mortality. In the meta-analysis of these studies, the pooled relative risk of ICU mortality was 1.03. A secondary meta-analysis of three smaller studies, which examined mortality only in patients directly assessed by the antimicrobial stewardship program, found a pooled relative risk of ICU mortality of 1.06.

Thus, researchers concluded that antimicrobial stewardship using audit and feedback in the ICU setting was not associated with a change in mortality.

"These results increase our confidence that audit and feedback can be safely implemented in this setting," they wrote.

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