Evidence map›Paper›PMID 30805182›Full record

SynthesisAntimicrobial resistance and infection control2019

Value of hospital antimicrobial stewardship programs [ASPs]: a systematic review.

Dilip Nathwani, Della Varghese, Jennifer Stephens, Wajeeha Ansari, Stephan Martin, Claudie Charbonneau

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Antimicrobial resistance and infection control, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 244 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
244citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

244 citing papers in PubMed, 11 syntheses or guidelines pooled it.

  1. Antimicrobial stewardship interventions in hospitalized adults with community-acquired pneumonia: a systematic review and meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025
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  3. Pathogenic characterization and drug resistance of neonatal sepsis in China: a systematic review and meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025
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184 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Dilip Nathwani1Ninewells Hospital and Medical School, Dundee, DD19SY UK.
Della Varghese2Pharmerit International, 4350 East West Highway, Suite 1100, Bethesda, MD 20184 USA.
Jennifer Stephens2Pharmerit International, 4350 East West Highway, Suite 1100, Bethesda, MD 20184 USA.ORCID 0000-0002-5623-7934
Wajeeha Ansari3Pfizer, New York City, NY USA.
Stephan Martin2Pharmerit International, 4350 East West Highway, Suite 1100, Bethesda, MD 20184 USA.
Claudie Charbonneau4Pfizer, Paris, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Hospital antimicrobial stewardship programs (ASPs) aim to promote judicious use of antimicrobials to combat antimicrobial resistance. For ASPs to be developed, adopted, and implemented, an economic value assessment is essential. Few studies demonstrate the cost-effectiveness of ASPs. This systematic review aimed to evaluate the economic and clinical impact of ASPs. Methods: An update to the Dik et al. systematic review (2000-2014) was conducted on EMBASE and Medline using PRISMA guidelines. The updated search was limited to primary research studies in English (30 September 2014-31 December 2017) that evaluated patient and/or economic outcomes after implementation of hospital ASPs including length of stay (LOS), antimicrobial use, and total (including operational and implementation) costs. Results: One hundred forty-six studies meeting inclusion criteria were included. The majority of these studies were conducted within the last 5 years in North America (49%), Europe (25%), and Asia (14%), with few studies conducted in Africa (3%), South America (3%), and Australia (3%). Most studies were conducted in hospitals with 500-1000 beds and evaluated LOS and change in antibiotic expenditure, the majority of which showed a decrease in LOS (85%) and antibiotic expenditure (92%). The mean cost-savings varied by hospital size and region after implementation of ASPs. Average cost savings in US studies were $732 per patient (range: $2.50 to $2640), with similar trends exhibited in European studies. The key driver of cost savings was from reduction in LOS. Savings were higher among hospitals with comprehensive ASPs which included therapy review and antibiotic restrictions. Conclusions: Our data indicates that hospital ASPs have significant value with beneficial clinical and economic impacts. More robust published data is required in terms of implementation, LOS, and overall costs so that decision-makers can make a stronger case for investing in ASPs, considering competing priorities. Such data on ASPs in lower- and middle-income countries is limited and requires urgent attention.

Indexed as

Antimicrobial StewardshipAmericasAnti-Bacterial AgentsAsiaAustraliaBacteriaBacterial InfectionsDrug Resistance, BacterialEuropeHospitalsHumansLength of StayAnti-Bacterial AgentsAntibiotic stewardship programAntimicrobial resistanceAntimicrobial stewardshipEconomic evaluation

Identifiers

PMID30805182
PMCPMC6373132

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.