The impact of infectious diseases specialists on antibiotic prescribing in hospitals.
Clin Microbiol Infect. 2014 Jul 4;
Authors: Pulcini C, Botelho-Nevers E, Dyar OJ, Harbarth S
Abstract
Given the current bacterial resistance crisis, antimicrobial stewardship programmes are of utmost importance. We present here a narrative review of the impact of infectious diseases specialists (IDS) on the quality and quantity of antibiotic use in acute care hospitals, and discuss the main factors that could limit the efficacy of IDS recommendations. A total of 31 studies were included in this review, with a wide range of infections, hospital settings and types of antibiotic prescriptions. Seven of 31 studies were randomised controlled trials, before/after controlled studies or before/after uncontrolled studies with interrupted time-series analysis. In almost all studies, IDS intervention was associated with a significant improvement of the appropriateness of antibiotic prescribing compared with prescriptions without any IDS input, and with decreased antibiotic consumption. Variability in the antibiotic prescribing practices of IDS, informal (curbside) consultations, involvement of junior IDS are among the factors that could have an impact on the efficacy of IDS recommendations and on compliance rates, and deserve further investigation. We also discuss possible drawbacks of IDS in acute care hospitals that are rarely reported in the published literature. Overall, IDS are valuable to antimicrobial stewardship programmes in hospitals, but their impact depends on many human and organisational factors. This article is protected by copyright. All rights reserved.
PMID: 25039787 [PubMed - as supplied by publisher]