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Table 5 Identified gaps and potential targets for antibiotic stewardship interventions

From: Identifying targets for antibiotic stewardship interventions through analysis of the antibiotic prescribing process in hospitals - a multicentre observational cohort study

Gaps identified Potential targets
Guideline adherence increased the use of narrow spectrum WHO Access group antibiotics in this study setting Promoting adherence to guidelines when prescribing empirical antibiotic therapy
Antibiotic therapy was initiated in the emergency room for 83.6% of patients Targeting antibiotic prescribing in the emergency room, focusing on first line clinical staff
Non-adherence to antibiotic guideline was associated with admittance from another institution Understanding the drivers for non-adherence in patients admitted from institutions and focusing on antibiotic prescribing for this group of patients
Non-adherence to antibiotic guideline was associated with the place of initiation of therapy, both regarding hospital site and wards compared to emergency room Understanding the cultural and contextual drivers for antibiotic prescribing across institutions and specialties
Mean length of antibiotic therapy was similar across very different groups of diagnosis. Focusing on reducing the duration of antibiotic therapy safely, in accordance with emerging evidence on duration of antibiotic treatment
Antibiotics prescribed upon discharge contributed significantly to the total days of antibiotic therapy and the appropriateness of this practice is often not clear