SynthesisJournal of the American Geriatrics Society2019
Antimicrobial Stewardship Programs in Long-Term Care Settings: A Meta-Analysis and Systematic Review.
Synthesis in Journal of the American Geriatrics Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
40 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Implementation of antimicrobial stewardship interventions on prescribing rates for urinary tract infections in residential aged care facilities: a systematic review and meta-analysis.Systematic reviews · 2026Pooled it
- Efficacy of telemedicine-based antimicrobial stewardship program to combat antimicrobial resistance: A systematic review and meta-analysis.Journal of telemedicine and telecare · 2025Pooled it
- How do aged-care staff feel about antimicrobial stewardship? A systematic review of staff attitudes in long-term residential aged-care.Antimicrobial resistance and infection control · 2022Pooled it
- Pooled it
- Interventions to improve appropriate antibiotic prescribing in long-term care facilities: a systematic review.BMC geriatrics · 2020Pooled it
- Effect of a multifaceted antibiotic stewardship intervention to improve antibiotic prescribing for suspected urinary tract infections in frail older adults (ImpresU): pragmatic cluster randomised controlled trial in four European countries.BMJ (Clinical research ed.) · 2023Trial
- Population-Wide Peer Comparison Audit and Feedback to Reduce Antibiotic Initiation and Duration in Long-Term Care Facilities with Embedded Randomized Controlled Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Trial
- Barriers to facilitate antimicrobial stewardship of hospital clinicians in Korea: a mixed-methods study using a qualitative study and survey results.Antimicrobial resistance and infection control · 2026Article
- Antimicrobial use and stewardship activities in Swiss long-term care facilities: data from a national point-prevalence survey.Antimicrobial resistance and infection control · 2026Article
- Physicians' understanding of antibiotic prescribing in Korean long-term care hospitals: a multicenter cross-sectional study.Journal of health, population, and nutrition · 2026Article
- Advancing antimicrobial stewardship programs in retirement homes: a quality improvement pilot using prospective audit and feedback.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Antibiotic stewardship practices at community living centers for veterans.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Antimicrobial stewardship in long term care facilities: evidence based interventions, implementation tools, and impact metrics.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Review
- Exploration of interprofessional collaboration for the diagnosis of infections and antibiotic prescription in nursing homes using multiple case study observational research.JAC-antimicrobial resistance · 2025Article
- Feasibility of Licensed Vocational Nurses Using a CDS App to Communicate Signs and Symptoms of a UTI.Nursing research and practice · 2025Article
- Using behavioural science to improve antibiotic stewardship in Canadian long-term care homes: Protocol for a multi-center cluster randomized quality improvement study.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2025Article
- Antibiotic Prescribing for Urinary Tract Infections in Women Residing in Long-Term Care: A Retrospective Cohort Study.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2024Article
- Barriers to the implementation of antimicrobial stewardship programmes in long-term care facilities: a scoping review.The Journal of antimicrobial chemotherapy · 2024Article
- What influences antibiotic initiation? Developing a scale to measure nursing behaviour in residential aged-care facilities.Nursing open · 2024Article
- Development of a risk prediction model for subsequent infection after colonization with carbapenem-resistant Enterobacterales: a retrospective cohort study.Antimicrobial resistance and infection control · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntimicrobial stewardship programs have been established in hospitals, but less studied in long-term care facilities (LTCFs), a setting with unique challenges related to patient populations and available resources. This systematic review sought to provide a comprehensive assessment of antimicrobial stewardship interventions implemented in LTCFs, using meta-analysis to examine their impact on overall antimicrobial use.
methodsElectronic searches of MEDLINE, Embase, and CINAHL (1990 to July 2018) identified any antimicrobial stewardship interventions in LTCFs, with no restriction on patient population, study design, or outcomes. Intervention components were categorized using the Cochrane Effective Practice and Organization of Care taxonomy on implementation strategies. Random-effects meta-analysis used ratio of means to facilitate pooling of different metrics of antimicrobial use.
resultsEighteen studies (one randomized controlled trial [RCT], four cluster RCTs, four controlled pre/post studies, and nine uncontrolled pre/post studies) met inclusion, using 13 different antimicrobial stewardship intervention strategies; 15 studies used multifaceted (maximum, seven; median, four) interventions. The three most commonly implemented strategies were educational materials, educational meetings, and guideline implementation. Intervention labor intensity and resource requirements varied considerably among interventions. Meta-analysis of 11 studies demonstrated that antimicrobial stewardship strategies were associated with a 14% reduction in overall antimicrobial use (95% confidence interval = -8% to -20%; P < .0001), with similar results by study design but high heterogeneity (I
conclusionAntimicrobial stewardship strategies implemented in long-term care vary considerably in design and resource intensity, but collectively suggest potential to reduce antimicrobial use in this challenging setting. J Am Geriatr Soc 67:392-399, 2019.
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