Reviewed by Barry Rittmann, MD, MPH, Virginia Commonwealth University
Prospective audit and feedback (A&F) is a core strategy in antimicrobial stewardship programs (ASP), although variations in AF practices have had inconsistent results in randomized control trials. In an article published in the February issue of CID, a systematic review and meta-analysis attempted to evaluate key factors in an effective A&F program. Researchers reviewed 56 RCTs across primary care settings across multiple countries. Studies varied between adult, nursing home, and pediatric population. Outcomes included total antibiotic prescribing volume, unnecessary antibiotic initiation, excessive prescription duration, and broad-spectrum antibiotic selection. They found improvements in all 4 outcomes, although there was significant heterogenicity between studies lack of standardization in outcome measurements. They identified that more frequent interventions were more effective, and programs that had higher baseline antibiotic use had a more profound benefit. Overall, this article can be especially useful in any ASP looking to initiate an A&F program.
Reference:
Xu AXT, Brown K, Schwartz KL, et al. Audit and feedback interventions for antibiotic prescribing in primary care: a systematic review and meta-analysis. Clin Infect Dis. 2025;80(2):253-262. doi:10.1093/cid/ciae604.