Skip main navigation

New offer! Get 30% off one whole year of Unlimited learning. Subscribe for just £249.99 £174.99. New subscribers only. T&Cs apply

Find out more

Unintended negative consequences

Discussion about the unintended consequences that may arise from any antimicrobial stewardship initiative
Hole in the shape of a question mark with a ladder going down the base of the shape
© flickr photo by shared under a Creative Commons (BY) license
All quality improvement initiatives can have unintended negative consequences and it is important to think about and try and predict such problems before implementation.

For example, the introduction of a pneumonia guideline that aims to speed up the administration of guideline-adherent antibiotics to pneumonia patients may result in an increase in the prescribing of antibiotics for patients with non-infection, acute cardio-respiratory conditions.

The diagnostic accuracy of physicians may decrease due to the imperative to prescribe more quickly.

Likewise, restrictive antibiotic stewardship strategies could increase the door-antibiotic-time for patients with severe infection if the approval process for certain antibiotics is too cumbersome. It is therefore important to consider ‘balancing measures’ such as measurement of the proportion of patients with severe infection who receive antibiotics within 1 hour of admission (or detection) and 30-day mortality.

The issues of negative consequences and balancing measures will be referred to again in Week 3 when we look at measurement.

© UoD and BSAC
This article is from the free online

Antimicrobial Stewardship: Managing Antibiotic Resistance

Created by
FutureLearn - Learning For Life

Reach your personal and professional goals

Unlock access to hundreds of expert online courses and degrees from top universities and educators to gain accredited qualifications and professional CV-building certificates.

Join over 18 million learners to launch, switch or build upon your career, all at your own pace, across a wide range of topic areas.

Start Learning now