Interventions to improve antibiotic prescribing practices

Passive education alone (e.g. lectures, educational events), without active intervention, has been shown to be only marginally effective in changing antimicrobial prescribing practices and has no sustained impact.

You are therefore advised not to rely solely on didactic educational materials for stewardship and passive educational activities should be used to complement other stewardship activities.

There are many different stewardship activities for improving the prescribing of antibiotics, either:

persuasive (e.g audit and feedback) or restrictive (e.g formulary restriction and pre-authorisation)

Currently there is a move towards the utilisation of prospective audits and feedback, which represents one of the two core strategies recommended by the IDSA/SHEA guideline and is a A-I level recommendation (evidence from ≥1 properly randomised clinical trial and good evidence to support recommendation for use).

Prospective audits and feedback are considered “real-time” approaches.

Considering Aalaa Afdal’s videos on measurement consider how in your institution antimicrobial use can be:

• reviewed after antimicrobial therapy has been initiated, and recommendations made with regard to their appropriateness in terms of several defined measurements.

• how it can be implemented in your health care facility irrespective of its size?