# | Author (s) | Year | Title | Study description | Extracted implementation topics |
---|---|---|---|---|---|
1 | Bannan, Buono, McLaws, Gottlieb | 2009 | Survey of medical staff attitudes to an antibiotic approval and stewardship program | Design: | - restriction as intervention |
Questionnaire with 40 questions focused on restriction and approval | - authorization as intervention | ||||
Interest: | - advice as communication | ||||
- education as intervention | |||||
Attitude | - stop-order (withholding pharmacy) as intervention | ||||
- costs, appropriate use, resistance, time as outcomes | |||||
- pager as communication | |||||
- possible stakeholders in team | |||||
2 | Barlam, DiVall | 2006 | Antibiotic-stewardship practices at top academic centers throughout the united states and at hospitals throughout Massachusetts | Design: | - multifaceted programs |
Two surveys | - time of start with ASP | ||||
Interest: | - funding/financial support | ||||
ASP components | - (formulary) restriction as intervention | ||||
- solicited input from ID as communication | |||||
- costs, improved use, adverse effects, resistance, compliance, DDDs, clinical outcomes as outcomes | |||||
- aiming prophylaxis | |||||
- aiming only targeted antibiotics | |||||
- aiming antibiotic therapy at order | |||||
- aiming initial therapy | |||||
- recommendations as intervention (day 3 bundle) | |||||
- culture data as communication | |||||
- possible stakeholders in team | |||||
- approval as intervention | |||||
- review as communication | |||||
- consult as communication | |||||
- computerized order entry as communication | |||||
- stop-order as intervention | |||||
- IV-PO switch as intervention | |||||
- clinical practical guidelines as intervention | |||||
- evaluation as intervention (benchmarking) | |||||
- support and time needed from physicians | |||||
- rounds, didactics, program, consults/feedback as education | |||||
3* | Burgmann, Janata, Allerberger, Frank | 2008 | Hospital antibiotic management in Austria – results of the ABS maturity survey of the ABS International group | Design: | - data evaluation as intervention (benchmarking) |
Survey | - AB consumption data as outcomes | ||||
Interest: | - hospital/department/ward levels of benchmarking | ||||
5 categories of maturity | - feedback of benchmarking as communication | ||||
- possible stakeholders in team | |||||
- guidelines for dosage, drug costs, IV-PO switch | |||||
- guidelines for antibiotic treatment | |||||
- guidelines for prophylaxis | |||||
- education as intervention (seminars, literature) | |||||
- financial resources | |||||
- cooperation with other hospitals | |||||
4 | Buyle, Metz-Gercek, Mechtler, Kern, Robays, Vogelaers, Struelens | 2013 | Development and validation of potential structure indicators for evaluating antimicrobial stewardship programmes in European hospitals | Design: | - bedside advice as communication |
Expert panel + validation survey | - rounds as intervention | ||||
- frequency of team meetings | |||||
Interest: | - audit as intervention | ||||
Potential structure indicators for ASP | - possible stakeholders in team | ||||
- formulary as intervention | |||||
- updating formulary | |||||
- stop order as intervention | |||||
- guidelines for microbiological documented therapy, empirical therapy, prophylaxis, iv-po switches | |||||
- updating guidelines | |||||
- clinical decision aid as IT | |||||
- mandate from management | |||||
- FTEs | |||||
- Education as interventions | |||||
- passive methods, interactive methods as education | |||||
- evaluation as intervention | |||||
- resistance data, consumption data, | |||||
- hospital/department/ward levels of benchmarking | |||||
- total DDDs, # of infections as outcomes | |||||
5 | Cooke, Alexander, Charani, Hand, Hills, Howard, Jamieson, Lawson, Richardson, Wade | 2010 | Antimicrobial stewardship: an evidence-based, antimicrobial self-assessment toolkit (ASAT) for acute hospitals | Design: | - guidelines as intervention |
ASAT toolkit (checklist) | - formulary as intervention | ||||
Interest: | - restriction as intervention | ||||
Levels of antimicrobial stewardship | - IV-PO switches as intervention | ||||
- guidelines for prophylaxis as intervention | |||||
- adherence as outcome | |||||
- education as intervention | |||||
- training as education | |||||
- information systems as IT | |||||
- digital prescribing as IT | |||||
- possible stakeholders in team | |||||
6 | Dumartin, Rogues, Amadeo, Pefau, Venier, Parneix, Maurain | 2011 | Antibiotic stewardship programmes: legal framework and structure and process indicator in Southwestern French hospitals, 2005–2008 | Design: | - frequency in meetings |
Survey | - available human resources | ||||
Interest: | - digital prescription, pharmaceutical analysis, dispensation, digital link between lab, pharm, wards as IT | ||||
Checking whether legal framework is present | - restriction as intervention | ||||
- stop order as intervention | |||||
- first-line, prophylaxis as guidelines | |||||
- audits as intervention/communication | |||||
- evaluation feedback as communication | |||||
- education as intervention | |||||
- Formulary as intervention | |||||
- ab consumption as benchmarking | |||||
- DDDs, resistance as outcomes (and communication) | |||||
- possible stakeholders in team | |||||
7 | van Gastel, Costers, Peetermans, Struelens | 2010 | Nationwide implementation of antibiotic management teams in Belgian hospitals: a self-reporting survey | Design: | - Possible stakeholders in team |
Questionnaire | - consultation per phone, email, intranet, face-to-face, staff meetings as communication | ||||
Interest: | - formulary as intervention | ||||
Level of AMT activities | - guidelines for empirical and prophylaxis | ||||
- updates of formulary and guidelines | |||||
- restriction as intervention | |||||
- approval/review as intervention | |||||
- concurrent review/audit as intervention | |||||
- de-escalation as intervention | |||||
- stop order as intervention | |||||
- order forms as intervention | |||||
- IV-PO switch as intervention | |||||
- consumption and resistance as outcomes | |||||
- by hospital/unit or by antibiotic type | |||||
- feedback of outcomes | |||||
8 | Greater New York Hospital Association | 2011 | Antimicrobial stewardship toolkit | Design: | - benchmark and review antibiotic use (patterns) |
Best practice | - review resistance | ||||
Interest: | - IT infrastructure | ||||
Implementation toolkit | - possible stakeholders in team | ||||
- aim for common infections, pathogens, agents | |||||
- rollout: hospital vs. ward | |||||
- available resources | |||||
- strategy: | |||||
- guidelines for diagnosis, treatment, duration, dose optimization, IV-PO, streamlining/de-escalation | |||||
- formulary as intervention | |||||
- restriction as intervention | |||||
- education as intervention | |||||
- prospective review as intervention | |||||
- stickers, notes, face-to-face as communication | |||||
- data collection (benchmarking) | |||||
- usage, clinical, microbiologic, costs as data | |||||
9 | Hulscher, Grol, van der Meer | 2010 | Antibiotic prescribing in hospitals: a social and behavioral scientific approach | Design: | - formulary as intervention |
Review | - order form as intervention | ||||
Interest: | - restriction as intervention | ||||
socio-cultural factors of ASP | - stop orders as intervention | ||||
- infection control committee | |||||
- guidelines as intervention | |||||
- review as intervention | |||||
- rounds as intervention | |||||
- telephone advice as intervention | |||||
- improve infrastructure | |||||
- education as intervention | |||||
- conferences, seminars, skill training programs as education | |||||
- individual instructions (outreach, academic detailing) | |||||
- feedback of outcomes | |||||
- decision support via IT | |||||
10 | Nault, Beaudoin, Thirion, Gosselin, Cossette, Valiquette | 2008 | Antimicrobial stewardship in acute care centres: survey of 68 hospitals in Quebec | Design: | - Duration of ASP or busy setting up |
Questionnaire | - distributed units, DDDs, acquisition costs as benchmarking data | ||||
Interest: | - direct interaction as intervention (written or phone) | ||||
Proportion and nature of programs | - education as intervention | ||||
- stop orders as intervention | |||||
- auto substitution | |||||
- formulary restriction as interventions | |||||
- local guidelines as intervention | |||||
- preauthorization as intervention | |||||
- antibiotic cycling as intervention | |||||
- decision support systems as intervention | |||||
- possible stakeholders in team | |||||
11 | Pulcini, Williams, Molinari, Davey, Nathwani | 2011 | Junior doctors’ knowledge and perceptions of antibiotic resistance and prescribing: a survey in France and Scotland | Design: | - local guidelines as intervention |
Survey | - presence of team- | ||||
Interest: | - approval as intervention | ||||
Perception and prescribing practice | - IV-PO switch protocol | ||||
- advice from ID physician, senior, microbiologist, pharmacist or team as intervention | |||||
- face-to-face, phone, consult upon request as communication | |||||
- lectures, workshops, informal education, web-based learning, self-directed learning as education | |||||
- possible stakeholders in team | |||||
- computer aided prescribing as IT | |||||
- resistance data availability | |||||
12 | Thern | 2013 | Selection of hospital antimicrobial prescribing quality indicators: | Design: | - possible stakeholders in team |
a consensus among German antibiotic stewardship (ABS) networkers | Review+ | - frequency of meetings | |||
questionnaire | - mandate | ||||
Interest: | - drug use, resistance rates as data | ||||
Indicators for quality of AB prescribing | - formulary as intervention | ||||
- updating formulary | |||||
- restriction/approval as intervention | |||||
- guidelines for empiric therapy, IV-PO, dosing, prophylaxis, | |||||
- rounds as intervention | |||||
- education as intervention | |||||
- guidance or assisted decision analysis via IT | |||||
13 | Trivedi, Rosenberg | 2013 | The state of antimicrobial stewardship programs in California | Design: | - implemented or planned ASP |
Survey | - time of start with ASP | ||||
Interest: | - possible stakeholders in team | ||||
State of ASP | - FTE availability | ||||
- - funding | |||||
- benchmarking as intervention | |||||
- DDDs, DOTs, costs, acceptance of recommendations, improved susceptibility patterns as data | |||||
- use of IT in ASP | |||||
- electronic health record, digital prescription, electronic medication administration records as IT | |||||
- formulary restriction as intervention | |||||
- ID physician consult as intervention | |||||
- audit as intervention | |||||
- prior approval as intervention | |||||
- auto stop orders as intervention | |||||
- verbal approval as intervention | |||||
- pre-authorization as intervention | |||||
- education as intervention | |||||
- guidelines as intervention | |||||
- IV-PO switch as intervention | |||||
- streamlining/de-escalation as intervention | |||||
 |  |  |  |  | - order forms as intervention |