Hospitals across the globe have taken varied approaches to antibiotic stewardship in efforts to combat the growth of antibiotic resistance. A new Cochrane Review found a number of interventions are effective at reducing unnecessary antibiotic use.
Researchers reviewed 221 studies from the U.S., Europe, Asia, South America and Australia and assessed the effectiveness and safety of antibiotic prescription interventions.
Interventions fall in two large categories: restrictive and enabling. Restrictive tactics apply rules to make physicians prescribe properly, while enabling tactics give advice or feedback to physicians to help them make prescribing decisions.
The researchers found interventions that included restrictive or enabling techniques were more effective than interventions that involved distributing guidelines alone.
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Adding enabling techniques typically increased the effectiveness of restrictive tactics. The most effective enabling techniques were goal-setting, feedback and action planning, but they were used in just 10 percent of interventions.
"We found high-certainty evidence that interventions are effective in increasing compliance with antibiotic policy and reducing duration of antibiotic treatment," the study concludes.
The study's lead author, Dr. Peter Davey with the University of Dundee in the U.K., added, "We do not need more studies to answer the question of whether these interventions reduce unnecessary antibiotic use, but we do need more research to understand why the most effective behavior change techniques are not more widely adopted within hospital settings…Appropriate antibiotic use in hospitals should ensure effective treatment of patients with infection and reduce unnecessary prescriptions. Successful adoption of the interventions we have studied could have considerable impact on health service, policy, and future decision-making for patients."