Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Population-Wide Peer Comparison Audit and Feedback to Reduce Antibiotic Initiation and Duration in Long-Term Care Facilities with Embedded Randomized Controlled Trial.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03807466 (Feedback to Improve Rational Strategies of Antibiotic Initiation and Duration in Long Term), which is not on this map. Cited by 22 papers, 2 of them syntheses that pooled it.
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.
Feedback to Improve Rational Strategies of Antibiotic Initiation and Duration in Long Term
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025Pooled it
- Audit and Feedback Interventions for Antibiotic Prescribing in Primary Care: A Systematic Review and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Pooled it
- Effect of a Feedback Visit and a Clinical Decision Support System Based on Antibiotic Prescription Audit in Primary Care: Multiarm Cluster-Randomized Controlled Trial.Journal of medical Internet research · 2024Trial
- Process evaluation of two large randomized controlled trials to understand factors influencing family physicians' use of antibiotic audit and feedback reports.Implementation science : IS · 2024Trial
- Physician Education and Peer Comparisons to Reduce Cardiovascular Risk Among People Living with HIV: A Stepped-Wedge Cluster Randomized Trial.AIDS and behavior · 2026Article
- Sickness Absence Duration Across Twenty Different Pathologies: A Systematic Review.Journal of occupational rehabilitation · 2026Review
- Barriers and facilitators to implementing antimicrobial stewardship (AMS) in a Chinese tertiary hospital: a qualitative study based on the Consolidated Framework for Implementation Research (CFIR).BMC infectious diseases · 2026Article
- Association Between Peer Comparison Feedback and Hospitalist Antibiotic Prescribing.JAMA network open · 2026Article
- Barriers and facilitators of the implementation for the antimicrobial Social Norm Feedback (SNF) intervention strategy in primary care institutions: a qualitative study based on the Consolidated Framework for Implementation Research (CFIR).Antimicrobial resistance and infection control · 2025Article
- The impact of infectious disease consult on a hospitalist prescribing metric of broad-spectrum antibiotics.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Barriers to the implementation of antimicrobial stewardship programmes in long-term care facilities: a scoping review.The Journal of antimicrobial chemotherapy · 2024Article
- Incorporating clinician insight and care plans into an audit and feedback initiative for antipsychotic prescribing to Medicaid-enrolled youth in Philadelphia.BMC health services research · 2024Article
- Derivation of a risk-adjusted model to predict antibiotic prescribing among hospitalists in an academic healthcare network.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Sustainability, spread, and scale in trials using audit and feedback: a theory-informed, secondary analysis of a systematic review.Implementation science : IS · 2023Article
- Regional and national antimicrobial stewardship activities: a survey from the Joint Programming Initiative on Antimicrobial Resistance-Primary Care Antibiotic Audit and Feedback Network (JPIAMR-PAAN).JAC-antimicrobial resistance · 2023Article
- The Effectiveness of Interactive Dashboards to Optimise Antibiotic Prescribing in Primary Care: A Systematic Review.Antibiotics (Basel, Switzerland) · 2023Review
- Antibiotic Selection and Duration for Catheter-Associated Urinary Tract Infection in Non-Hospitalized Older Adults: A Population-Based Cohort Study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Antibiotic prescribing and antimicrobial stewardship in long-term care facilities: Past interventions and implementation challenges.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2022Article
- A Baker's Dozen of Top Antimicrobial Stewardship Intervention Publications in Non-Hospital Care Settings in 2021.Open forum infectious diseases · 2022Review
- A Time Series Analysis Evaluating Antibiotic Prescription Rates in Long-Term Care during the COVID-19 Pandemic in Alberta and Ontario, Canada.Antibiotics (Basel, Switzerland) · 2022Article
Corrections and comments
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Authors and funding
19 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundAntibiotic overprescribing in long-term care settings is driven by prescriber preferences and is associated with preventable harms for residents. We aimed to determine whether peer comparison audit and feedback reporting for physicians reduces antibiotic overprescribing among residents.
methodsWe employed a province wide, difference-in-differences study of antibiotic prescribing audit and feedback, with an embedded pragmatic randomized controlled trial (RCT) across all long-term care facilities in Ontario, Canada, in 2019. The study year included 1238 physicians caring for 96 185 residents. In total, 895 (72%) physicians received no feedback; 343 (28%) were enrolled to receive audit and feedback and randomized 1:1 to static or dynamic reports. The primary outcomes were proportion of residents initiated on an antibiotic and proportion of antibiotics prolonged beyond 7 days per quarter.
resultsAmong all residents, between the first quarter of 2018 and last quarter of 2019, there were temporal declines in antibiotic initiation (28.4% to 21.3%) and prolonged duration (34.4% to 29.0%). Difference-in-differences analysis confirmed that feedback was associated with a greater decline in prolonged antibiotics (adjusted difference -2.65%, 95% confidence interval [CI]: -4.93 to -.28%, P = .026), but there was no significant difference in antibiotic initiation. The reduction in antibiotic durations was associated with 335 912 fewer days of treatment. The embedded RCT detected no differences in outcomes between the dynamic and static reports.
conclusionsPeer comparison audit and feedback is a pragmatic intervention that can generate small relative reductions in the use of antibiotics for prolonged durations that translate to large reductions in antibiotic days of treatment across populations. Clinical Trials Registration. NCT03807466.
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Registered trials
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.