Clin Microbiol Infect. 2022 Aug 19:S1198-743X(22)00393-7. doi: 10.1016/j.cmi.2022.07.025. Online ahead of print.
ABSTRACT
BACKGROUND: Based on multiple randomized controlled clinical trials, shorter antibiotic courses are equally effective as traditional longer courses for many types of infections. However, longer courses are still being used widely in clinical practice.
OBJECTIVE: To describe four components involved in the successful implementation of shorter antibiotic courses in our healthcare institutions, including an academic, public hospital and a community hospital staffed primarily by private practitioners.
SOURCES: Clinical trials and peer-reviewed publications.
CONTENT: We provide practical advice on how to support the change in clinical practice to shorten antibiotic duration. Specifically, we list steps we have successfully used to develop and implement an institutional practice change regarding duration of antibiotic therapy: 1) establishing consensus documents outlining a data-driven expected practice for using antibiotics, 2) antibiotic stewardship program (ASP) support, 3) provider education and 4) reinforcing behavior through psychological and other tools. Implementation of these processes has successfully led to shorter antibiotic courses and decreased antibiotic utilization in our diverse practice settings.
IMPLICATIONS: Intentional improvement in decreasing duration of antibiotic therapy can be achieved by specific ASP strategy and tactics. The implementation of shorter antibiotic courses has effects at individual and societal levels in an era of increasing antibacterial resistance and healthcare costs.
PMID:35995403 | DOI:10.1016/j.cmi.2022.07.025