ArticlePloS one2016
Impact of a Prospective Audit and Feedback Antimicrobial Stewardship Program at a Veterans Affairs Medical Center: A Six-Point Assessment.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed.
- Impact of a post-prescription audit and feedback antimicrobial stewardship intervention on inappropriate carbapenem prescribing: an interrupted time series analysis.JAC-antimicrobial resistance · 2025Article
- Impact of Adherence With In-Patient Prospective Audit and Feedback Recommendations on Patient and Economic Outcomes.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2025Article
- Prospective Audit and Feedback of Targeted Antimicrobials Use at a Tertiary Care Hospital in the United Arab Emirates.Antibiotics (Basel, Switzerland) · 2025Article
- Prospective Audit and Feedback for Antimicrobial Treatment of Patients Receiving Renal Replacement Therapy in Community-Based University Hospitals: A before-and-after Study.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Establishing obstetrics-specific metrics and interventions for antimicrobial stewardship.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2023Article
- Effectiveness of Noncertified Pharmacist-Led Antimicrobial Stewardship Programs in a Medium-Sized Hospital Without an Infectious Disease Specialist: A Retrospective Pre-Post Study.Open forum infectious diseases · 2023Article
- Antimicrobial Prescribing in the Telehealth Setting: Framework for Stewardship During a Period of Rapid Acceleration Within Primary Care.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Review
- White paper on antimicrobial stewardship in solid organ transplant recipients.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022Article
- Use of monitoring indicators in hospital management of antimicrobials.BMC infectious diseases · 2021Observational
- Evaluating a Pharmacy-Driven 72-Hour Antibiotic Monitoring Program Implemented in a Community Hospital.Hospital pharmacy · 2021Article
- Assessment of Appropriateness of Antimicrobial Therapy in Resource-Constrained Settings: Development and Piloting of a Novel Tool-AmRAT.Antibiotics (Basel, Switzerland) · 2021Article
- Out of Sight-Out of Mind: Impact of Cascade Reporting on Antimicrobial Usage.Open forum infectious diseases · 2020Article
- Characteristics of nursing homes with comprehensive antibiotic stewardship programs: Results of a national survey.American journal of infection control · 2020Article
- Implementation of a Health-System Wide Antimicrobial Stewardship Program in Omaha, NE.Pharmacy (Basel, Switzerland) · 2019Article
- Clinical outcomes in patients admitted to a hospitalist service exposed to an antimicrobial stewardship program - a retrospective matched cohort study.Antimicrobial resistance and infection control · 2019Article
- Role of pharmacists in antimicrobial stewardship programmes.International journal of clinical pharmacy · 2018Review
- The Hospital Antimicrobial Use Process: From Beginning to End.Open forum infectious diseases · 2018Article
- Assessments of Opportunities to Improve Antibiotic Prescribing in an Emergency Department: A Period Prevalence Survey.Infectious diseases and therapy · 2017Article
- Implementing Antimicrobial Stewardship in Long-term Care Settings: An Integrative Review Using a Human Factors Approach.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Review
- Inappropriate prescribing in outpatient healthcare: an evaluation of respiratory infection visits among veterans in teaching versus non-teaching primary care clinics.Antimicrobial resistance and infection control · 2017Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProspective audit and feedback is a core antimicrobial stewardship program (ASP) strategy; however its impact is difficult to measure.
methodsOur quasi-experimental study measured the effect of an ASP on clinical outcomes, antimicrobial use, resistance, costs, patient safety (adverse drug events [ADE] and Clostridium difficile infection [CDI]), and process metrics pre- (9/10-10/11) and post-ASP (9/12-10/13) using propensity adjusted and matched Cox proportional-hazards regression models and interrupted time series (ITS) methods.
resultsAmong our 2,696 patients, median length of stay was 1 day shorter post-ASP (5, interquartile range [IQR] 3-8 vs. 4, IQR 2-7 days, p<0.001). Mortality was similar in both periods. Mean broad-spectrum (-11.3%), fluoroquinolone (-27.0%), and anti-pseudomonal (-15.6%) use decreased significantly (p<0.05). ITS analyses demonstrated a significant increase in monthly carbapenem use post-ASP (trend: +1.5 days of therapy/1,000 patient days [1000PD] per month; 95% CI 0.1-3.0). Total antimicrobial costs decreased 14%. Resistance rates did not change in the one-year post-ASP period. Mean CDI rates/10,000PD were low pre- and post-ASP (14.2 ± 10.4 vs. 13.8 ± 10.0, p = 0.94). Fewer patients experienced ADEs post-ASP (6.0% vs. 4.4%, p = 0.06).
conclusionsProspective audit and feedback has the potential to improve antimicrobial use and outcomes, and contain bacterial resistance. Our program demonstrated a trend towards decreased length of stay, broad-spectrum antimicrobial use, antimicrobial costs, and adverse events.
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