Differences in stewardship strategies between hospitals performing well and poorly on a risk-adjusted metric for post-discharge antibiotic use

TL;DR

The study found that hospitals with better antibiotic use after discharge had stronger stewardship practices, like regular physician-pharmacist collaboration and local prescribing guidelines.

Contribution

Identifies specific stewardship practices associated with better antibiotic use outcomes in hospitals.

Findings

Low-performing hospitals were less likely to have regular physician-pharmacist interactions.

Low-performing hospitals were less likely to have local antibiotic-prescribing guidelines.

Abstract

Stewardship processes were compared across 123 hospitals that differed on a risk-adjusted post-discharge antibiotic use metric. Low-performing hospitals were less likely than high-performing hospitals to report routine interactions between their stewardship physician and pharmacist(s) (OR 0.12, 95% CI 0.03–0.55) and to have local antibiotic-prescribing guidelines (OR 0.21, 95% CI 0.05–0.93)

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