Antimicrobial stewardship programs are associated with reduced antibiotic use in multiple settings globally

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

Ya and colleagues describe their systematic review and meta-analysis investigating the association of antimicrobial stewardship programs (ASP) with antibiotic use.  They included 52 studies from varied practice settings (hospitalized patients, outpatients, long-term care), with varied patient populations (adult and pediatric patients) and across different economic strata, including low- and middle-income countries (LMIC) as well as high income countries (HIC).  The primary outcome assessed antibiotic consumption (measured by defined daily doses (DDD) or days of treatment per patient-days) and antibiotic prescriptions.  ASPs were associated with a 10% reduction in antibiotic prescriptions and a 28% reduction in antibiotic consumption rate overall.  Reduction in antibiotic consumption was noted in all antibiotic classes and was greatest in pediatric patients (as compared to adults), in LMIC (though only 5 countries represented) and when decision support tools were initiated.  Thus, despite the heterogeneity of practice settings, patient populations and economic drivers, ASPs are associated with reduced antibiotic use.           

Ya K, Win P, Bielicki J, et al.  Association between antimicrobial stewardship programs and antibiotic use globally: a systematic review and meta-analysis.  JAMA Network Open. 2023; 6(2): e2253806. doi: 10.1001/jamanetworkopen.2022.53806

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