Gentle “nudging” helps to improve antimicrobial stewardship

Reviewed by Cindy Noyes, MD, University of Vermont Medical Center, Burlington, VT

Schartz and colleagues describe a quasi-experimental intervention to reduce antifungal treatment for asymptomatic candiduria in hospitalized patients.  They describe addition of a guidance phrase embedded in urine culture microbiology results growing Candida species recommending avoidance of treatment in the absence of symptoms unless the patient has risk factors for severe illness or is undergoing a urologic procedure.  They measured antifungal use in the year prior to implementation and then following.  The authors were able to demonstrate a significant reduction in antifungal prescriptions in patients with asymptomatic candiduria without untoward effect, suggesting that templated guidance embedded in microbiology results can exert a reduction in unnecessary antifungal use. 

Reference: Schartz W et al (2022).  Templated microbiology comments with candiduria to enhance antimicrobial stewardship.  Antimicrobial Stewardship and Healthcare Epidemiology. https://doi:10.1017/ash.2022.292

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