1.

Record Nr.

UNINA9910717369103321

Autore

Filice Gregory

Titolo

Antimicrobial stewardship programs in inpatient settings : a systematic review / / Gregory Filice [and eight others]

Pubbl/distr/stampa

Washington, D. C. : , : Department of Veterans Affairs (US), , [2013]

©2013

Descrizione fisica

1 online resource (v, 144 pages) : illustrations

Collana

Evidence-based synthesis program

Disciplina

615.792

Soggetti

Anti-infective agents - Side effects

United States

Lingua di pubblicazione

Inglese

Formato

Materiale a stampa

Livello bibliografico

Monografia

Note generali

"Evidence-based synthesis program."

"September 2013."

Nota di bibliografia

Includes bibliographical references.

Sommario/riassunto

It is estimated that in 2009, more than 3 million kilograms of antimicrobials were administered to human patients in the United States. While the life-saving benefits of antimicrobials are indisputable, the consequences of use and misuse must also be considered. Major concerns related to the use of antimicrobials are increasing resistance, higher incidence of Clostridium difficile (C. difficile) infection (CDI) and increased healthcare costs (including costs related to adverse events associated with antimicrobial use). While much of the discussion focuses on overuse, there is also evidence of adverse outcomes associated with inadequate antimicrobial therapy. Antimicrobial stewardship programs (ASPs) are a focused effort by a health care system, a hospital, or a portion of a hospital (e.g., an intensive care unit) to optimize the use of antimicrobial agents. The goals of an ASP are to improve patient outcomes, reduce adverse consequences, reduce or prevent an increase in antimicrobial resistance, and deliver cost-effective therapy. The emphasis is on appropriate selection, dosing, route, and duration of antimicrobial therapy. The purpose of this review is to synthesize the evidence about the effectiveness of antimicrobial stewardship programs implemented in hospital settings. We focus on



ASPs including one or more of the following components: prospective audit and feedback, formulary restriction, pre-authorization of prescriptions, guidelines for prescribing and/or modifying therapy, computerized decision support, or laboratory testing. The topic was nominated by Matthew Goetz, MD, Chief, Infectious Diseases, VA Greater Los Angeles Healthcare System, on behalf of the VA Antimicrobial Stewardship Task Force, and is intended to provide a summary of the evidence on inpatient antimicrobial stewardship programs to guide clinical practice and policy within the Veterans Healthcare System.