ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
Antibiotic Stewardship Strategies and Their Association With Antibiotic Overuse After Hospital Discharge: An Analysis of the Reducing Overuse of Antibiotics at Discharge (Road) Home Framework.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06106204 (A Parallel Cluster Randomized Trial of a Participatory Approach to Reduce Overuse of Antibiotics at Hospital Discharge), which is not on this map. Cited by 11 papers.
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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.
A Parallel Cluster Randomized Trial of a Participatory Approach to Reduce Overuse of Antibiotics at Hospital Discharge: The ROAD Home Trial
Who cites it
11 citing papers in PubMed.
- Missed Antibiotic Doses, Microbiology Diagnostic Results, and Antibiotic Prescribing Patterns at Discharge at Two Paediatric Tertiary Hospitals in Zambia: Implications for Antimicrobial Stewardship.Antibiotics (Basel, Switzerland) · 2026Article
- Antibiotic Stewardship in Pediatric Urinary Tract Infections: Current Evidence and Practical Strategies.Antibiotics (Basel, Switzerland) · 2026Review
- Pediatric outpatient parenteral antibiotic therapy: an important option for pediatric hospitals in Germany.GMS hygiene and infection control · 2026Article
- Qualitative assessment of antibiotic stewardship teams' efforts to perform prospective audit-and-feedback at hospital discharge.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Optimizing oral antibiotic prescribing at hospital discharge: a single center, quasi-experiment pilot study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Excellence in Antibiotic Stewardship: A Mixed-Methods Study Comparing High-, Medium-, and Low-Performing Hospitals.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Accordance of Registered Drug Packages with Guideline-Recommended Treatment Durations for Community-Acquired Pneumonia-A New Antibiotic Stewardship Target?Antibiotics (Basel, Switzerland) · 2024Article
- Length of antibiotic therapy among adults hospitalized with uncomplicated community-acquired pneumonia, 2013-2020.Infection control and hospital epidemiology · 2024Article
- Appropriate Duration of Antimicrobial Treatment for Prosthetic Joint Infections: A Narrative Review.Antibiotics (Basel, Switzerland) · 2024Review
- Protocol for a parallel cluster randomized trial of a participatory tailored approach to reduce overuse of antibiotics at hospital discharge: the ROAD home trial.Implementation science : IS · 2024Article
- Antibiotic Stewardship Strategies and Their Association With Antibiotic Overuse After Hospital Discharge: An Analysis of the Reducing Overuse of Antibiotics at Discharge (Road) Home Framework.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundStrategies to optimize antibiotic prescribing at discharge are not well understood.
methodsIn fall 2019, we surveyed 39 Michigan hospitals on their antibiotic stewardship strategies. The association of reported strategies with discharge antibiotic overuse (unnecessary, excess, suboptimal fluoroquinolones) for community-acquired pneumonia (CAP) and urinary tract infection (UTI) was evaluated in 2 ways: (1) all strategies assumed equal weight and (2) strategies were weighted based on the ROAD (Reducing Overuse of Antibiotics at Discharge) Home Framework (ie, Tier 1-Critical infrastructure, Tier 2-Broad inpatient interventions, Tier 3-Discharge-specific strategies) with Tier 3 strategies receiving the highest weight.
resultsBetween 1 July 2017 and 30 July 2019, 39 hospitals with 20 444 patients (56.5% CAP; 43.5% UTI) were included. Survey response was 100%. Hospitals reported a median (interquartile range [IQR]) 12 (9-14) of 34 possible stewardship strategies. On analyses of individual stewardship strategies, the Tier 3 intervention, review of antibiotics prior to discharge, was the only strategy consistently associated with lower antibiotic overuse at discharge (adjusted incident rate ratio [aIRR] 0.543, 95% confidence interval [CI]: .335-.878). On multivariable analysis, weighting by ROAD Home tier predicted antibiotic overuse at discharge for both CAP and UTI. For diseases combined, having more weighted strategies was associated with lower antibiotic overuse at discharge (aIRR 0.957, 95% CI: .927-.987, per weighted intervention); discharge-specific stewardship strategies were associated with a 12.4% relative decrease in antibiotic overuse days at discharge.
conclusionsThe more stewardship strategies a hospital reported, the lower its antibiotic overuse at discharge. However, Tier 3, or discharge-specific strategies, appeared to have the largest effect on antibiotic prescribing at discharge.
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