ArticleOpen forum infectious diseases2020
Barriers to Adherence to Antimicrobial Stewardship Postprescription Review and Feedback For Broad-Spectrum Antimicrobial Agents: A Nested Case-Control Study.
Article in Open forum infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 14 citations in OpenAlex.
- Multilevel barriers to antimicrobial stewardship in tertiary care hospitals: A comparative systematic scoping review of high-income versus low-/middle-income countries evidence mapped by study design and healthcare professionals.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Clinical impact of broad- versus narrow-spectrum empiric therapy in acute cholangitis: A Japanese claims database study.PloS one · 2026Article
- Baseline predictors of antibiotics de-escalation from empirical therapies in an intensive care unit: a five-year retrospective study.BMC infectious diseases · 2025Article
- Retrospective analysis of 300 microbial cell-free DNA sequencing results in routine blood stream infection diagnostics.Frontiers in cellular and infection microbiology · 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
- Impact of prolonged carbapenem use-focused antimicrobial stewardship on antimicrobial consumption and factors affecting acceptance of recommendations: a quasi-experimental study.Scientific reports · 2023Article
- Comparing the Dosing Period in Package Inserts of Antimicrobial Agents Between Japan and the United States.Cureus · 2023Article
- Factors Associated With Acceptance of Telehealth-Based Antimicrobial Stewardship Program Recommendations in a Community Hospital Health System.Open forum infectious diseases · 2022Article
- Outpatient Antibiotic Prescribing Patterns and Appropriateness for Children in Primary Healthcare Settings in Beijing City, China, 2017-2019.Antibiotics (Basel, Switzerland) · 2021Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostprescription review and feedback (PPRF) is one of the most common strategies in antimicrobial stewardship program (ASP) intervention. However, disagreements between the prescribers and ASP personnel can occur. The aim of the present study was to identify the factors associated with nonadherence to PPRF intervention.
methodsThe present retrospective nested case-control study was performed at a tertiary care center, which has been conducting a once-weekly PPRF for carbapenems and piperacillin/tazobactam since 2014. Nonadherence to ASP recommendations was defined as the failure of the primary care team to modify or stop antimicrobial therapy 72 hours after the issuance of PPRF recommendations. Factors associated with nonadherence to PPRF intervention were identified using multivariate logistic regression analysis.
resultsIn total, 2466 instances of PPRF in 1714 cases between April 2014 and September 2019 were found. The nonadherence rate was 5.9%, and 44 cases were found in which carbapenems or piperacillin/tazobactam continued to be used against PPRF recommendations. Factors associated with nonadherence to PPRF recommendations were a previous history of hospitalization within 90 days (adjusted odds ratio [aOR], 2.62; 95% confidence interval [CI], 1.18-5.81) and a rapidly fatal McCabe score at the time of PPRF intervention (aOR, 2.87; 95% CI, 1.18-6.98). A review of the narrative comments in the electronic medical records indicated that common reasons for nonadherence were "the patient was sick" (n = 12; 27.3%) and "the antimicrobial seemed to be clinically effective" (n = 9; 20.5%).
conclusionsNonadherence to PPRF recommendations was relatively uncommon at the study institution. However, patients with a severe disease condition frequently continued to receive broad-spectrum antimicrobials against PPRF recommendations. Understanding physicians' cognitive process in nonadherence to ASP recommendations and ASP interventions targeting medical subspecialties caring for severely ill patients is needed to improve ASP.
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