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

**Authors:** Daniel J. Livorsi, James A. Merchant, Hyunkeun Cho, Matthew Bidwell Goetz, Bruce Alexander, Brice Beck, Michihiko Goto

PMC · DOI: 10.1017/ice.2024.237 · 2025-02-12

## 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.

## Key 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)

## Full-text entities

- **Diseases:** pneumonia (MESH:D011014), Infectious Disease (MESH:D003141), infection (MESH:D007239), skin and soft tissue infections (MESH:D018461), died (MESH:D003643), ID (MESH:C537985), urinary tract infections (MESH:D014552)
- **Chemicals:** ciprofloxacin (MESH:D002939), vancomycin (MESH:D014640), cefepime (MESH:D000077723), linezolid (MESH:D000069349), ertapenem (MESH:D000077727), piperacillin-tazobactam (MESH:D000077725), levofloxacin (MESH:D064704), daptomycin (MESH:D017576), ceftazidime (MESH:D002442), moxifloxacin (MESH:D000077266), carbapenems (MESH:D015780)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12015618/full.md

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Source: https://tomesphere.com/paper/PMC12015618