Summary
The role of antimicrobial stewardship programmes (ASPs) has expanded in health systems.
ASP interventions often contain an educational component; however, current guidelines
suggest that educational interventions should not be used alone but to support other
stewardship interventions. Such interventions are most commonly directed towards prescribers
(often general practice physicians) with few studies offering education towards other
healthcare providers such as pharmacists, nurses, or even members of the stewardship
team. Educational interventions are offered most frequently, but not exclusively,
with concomitant stewardship interventions such as prospective audit and feedback.
Such strategies appear to positively impact prescribing behaviours, but it is not
possible to isolate the effect of education from other interventions. Common educational
methods include one-time seminars and online e-learning modules, but unique strategies
such as social media platforms, educational video games and problem-based learning
modules have also been employed. Education directed towards patients often occurs
in conjunction with education of local prescribers and wider community-based efforts
to impact prescribing. Such studies evaluating patient education often include passive
educational leaflets and focus most often on appropriate treatment of upper respiratory
tract infections. Educational interventions appear to be an integral component of
other interventions of ASPs; however, there is a paucity of evidence to support use
as a stand-alone intervention outside of regional public health interventions. Future
studies should focus on efficacy of educational interventions including providing
education to non-prescribers and disease states beyond upper respiratory tract infections
to demonstrate a broader role for education in ASP activities.
Keywords
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References
- Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011.JAMA. 2016; 315: 1864-1873
- Prevalence of inappropriate antibiotic prescribing in primary care clinics within a Veterans Affairs health care system.Antimicrob Agents Chemother. 2018; 62: e00337
- Vital signs: improving antibiotic use among hospitalized patients.MMWR Morb Mortal Wkly Rep. 2014; 63: 194-200
- Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.Clin Infect Dis. 2016; 62: e51-e77
- Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis.Lancet Infect Dis. 2017; 17: 990-1001
- Core elements of hospital antibiotic stewardship programs from the Centers for Disease Control and Prevention.Clin Infect Dis. 2014; 59: S97-S100
- Core elements of hospital antibiotic stewardship programs.2019 (Available at:)https://www.cdc.gov/antibiotic-use/healthcare/pdfs/hospital-core-elements-H.pdfDate accessed: December , 2019
- Medical students’ perceptions and knowledge about antimicrobial stewardship: how are we educating our future prescribers?.Clin Infect Dis. 2013; 57: 631-638
- Distance learning in antimicrobial stewardship: innovation in medical education.BMC Med Educ. 2019; 19: 191-199
- How to educate prescribers in antimicrobial stewardship practices.Virulence. 2013; 4: 192-202
- A survey of knowledge, attitudes, and beliefs of house staff physicians from various specialties concerning antimicrobial use and resistance.Arch Intern Med. 2004; 164: 1451-1456
- Optimizing antibiotic usage in hospitals: a qualitative study of the perspectives of hospital managers.J Hosp Infect. 2016; 94: 230-235
- Health care provider education as a tool to enhance antibiotic stewardship practices.Infect Dis Clin North Am. 2014; 28: 177-193
- Interventions to improve antibiotic prescribing practices for hospital inpatients.Cochrane Database Syst Rev. 2017; 2017: CD003543
- Impact of an antimicrobial stewardship intervention on shortening the duration of therapy for community-acquired pneumonia.Clin Infect Dis. 2012; 54: 1581-1587
- Effectiveness of multifaceted educational programme to reduce antibiotic dispensing in primary care: practice based randomised controlled trial.BMJ. 2012; 344: d8173
- Can rational prescribing be improved by an outcome-based educational approach? A randomized trial completed in Iran.J Contin Educ Health Prof. 2010; 30: 11-18
- Improved empirical antibiotic treatment of sepsis after an educational intervention: the ABISS-Edusepsis study.Crit Care. 2018; 22: 167
- Education and communication in an interprofessional antimicrobial stewardship program.J Am Osteopath Assoc. 2016; 116: 588-593
- Effect of an outpatient antimicrobial stewardship intervention on broad-spectrum antibiotic prescribing by primary care pediatricians: a randomized trial.JAMA. 2013; 309: 2345-2352
- Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.Am J Infect Control. 2016; 44: 349-351
- The effect of re-audit and education on antibiotic prescribing practice at Causeway Hospital, Northern Ireland.Ir J Med Sci. 2019; 188: 1149-1153
- Antibiotic self-stewardship: trainee-led structured antibiotic time-outs to improve antimicrobial use.Ann Intern Med. 2014; 161: S53-S58
- C-reactive protein testing in patients with acute rhinosinusitis leads to a reduction in antibiotic use.Fam Pract. 2012; 29: 653-658
- Early switching of antibiotic therapy from intravenous to oral using a combination of education, pocket-sized cards and switch advice: A practical intervention resulting in a reduction in length of hospital stay.Int J Antimicrob Agents. 2020; 55: 105769
- A quality assessment of a collaborative model of a pediatric antimicrobial stewardship program.Pediatrics. 2016; 137e20150316
- Effects of a bundled antimicrobial stewardship program on mortality: a cohort study.Braz J Infect Dis. 2015; 19: 246-252
- Primary care nurses using guidelines in Thailand: a randomized controlled trial.Trop Med Int Health. 2005; 10: 471-477
- Antimicrobial stewardship in rural nursing homes: Impact of interprofessional education and clinical decision tool implementation on urinary tract infection treatment in a cluster randomized trial.Infect Control Hosp Epidemiol. 2019; 40: 432-437
- Social media as a tool for antimicrobial stewardship.Am J Infect Control. 2016; 44: 1231-1236
- What is the role of quality circles in strategies to optimise antibiotic prescribing? A pragmatic cluster-randomised controlled trial in primary care.Qual Saf Health Care. 2007; 16: 197-202
- Implementing guidelines on acute maxillary sinusitis in general practice—a randomized controlled trial.Fam Pract. 2007; 24: 201-206
- Impact of a multipronged education strategy on antibiotic prescribing in Quebec, Canada.Clin Infect Dis. 2011; 53: 433-439
- Forecasting implementation, adoption, and evaluation challenges for an electronic game-based antimicrobial stewardship intervention: co-design workshop with multidisciplinary stakeholders.J Med Internet Res. 2019; 21: e13365
- Inventory of antibiotic stewardship programs in general practice in France and abroad.Med Mal Infect. 2015; 45: 111-123
- Effectiveness of interventions in reducing antibiotic use for upper respiratory infections in ambulatory care practices.Popul Health Manag. 2013; 16: 22-27
- Antibiotic consumption successfully reduced by a community intervention program.Isr Med Assoc J. 2007; 9: 16-20
- Intervention with educational outreach at large scale to reduce antibiotics for respiratory tract infections: a controlled before and after study.Fam Pract. 2009; 26: 183-187
- A mixed methods study of the barriers and enablers in implementing antimicrobial stewardship programmes in Australian regional and rural hospitals.J Antimicrob Chemother. 2015; 70: 2665-2670
- Pilot study for appropriate anti-infective community therapy. Effect of a guideline-based strategy to optimize use of antibiotics.Can Fam Physician. 2000; 46: 851-859
- Participatory eHealth development to support nurses in antimicrobial stewardship.BMC Med Inform Decis Mak. 2014; 14: 45
- What do future pharmacists know about, and think of, antimicrobial stewardship?.Pharmacy Education. 2019; 19: 146-154
- Exploring the gaps between education and pharmacy practice on antimicrobial stewardship: a qualitative study among pharmacists in Qatar.Adv Med Educ Pract. 2019; 10: 287-295
- Antimicrobial stewardship training for infectious diseases fellows: program directors identify a curriculum need.Clin Infect Dis. 2018; 67: 1285-1287
- Antibiotic prescribing for acute cough: the effect of perceived patient demand.Br J Gen Pract. 2006; 56: 183-190
- Use of the health belief model to study patient perceptions of antimicrobial stewardship in the acute care setting.Infect Control Hosp Epidemiol. 2016; 37: 576-582
- Impact of a 16-community trial to promote judicious antibiotic use in Massachusetts.Pediatrics. 2008; 121: e15-e23
- Antibiotic treatment of acute respiratory tract infections in the elderly: effect of a multidimensional educational intervention.J Am Geriatr Soc. 2004; 52: 39-45
- Training family physicians in shared decision-making to reduce the overuse of antibiotics in acute respiratory infections: a cluster randomized trial.CMAJ. 2012; 184: e726-e734
- Information leaflet and antibiotic prescribing strategies for acute lower respiratory tract infection: a randomized controlled trial.JAMA. 2005; 293: 3029-3035
- A community intervention to decrease antibiotics used for self-medication among Latino adults.Ann Fam Med. 2009; 7: 520-526
- Cluster-randomized trial to improve antibiotic use for adults with acute respiratory infections treated in emergency departments.Ann Emerg Med. 2007; 50: 221-230
- Reduction in antibiotic use following a cluster randomized controlled multifaceted intervention: the Israeli judicious antibiotic prescription study.Clin Infect Dis. 2011; 53: 33-41
- Effect of a training and educational intervention for physicians and caregivers on antibiotic prescribing for upper respiratory tract infections in children at primary care facilities in rural China: a cluster-randomised controlled trial.Lancet Glob Health. 2017; 5: e1258-e1267
Article info
Publication history
Published online: March 31, 2020
Accepted:
March 23,
2020
Received:
January 6,
2020
Identification
Copyright
© 2020 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
