Antimicrobial stewardship interventions in the emergency department

Added April 26, 2020

Citation: Losier M, Ramsey TD, Wilby KJ, et al. A systematic review of antimicrobial stewardship interventions in the emergency department. Annals of Pharmacotherapy 2017; 51(9): 774-90

Free to view: No

What is this? The COVID-19 pandemic is placing a great strain on health systems and healthcare workers. Existing research on the use of antimicrobial stewardship programmes to improve the use of antimicrobials in emergency departments may provide information on strategies to help.

In this systematic review, the authors searched for research characterizing the use of antimicrobial stewardship programmes in emergency departments and evaluating related interventions that might improve patient care or health outcomes. They did not restrict by type of publication but restricted their searches to articles published in English before November 2016. They included 43 studies, 36 of which used an uncontrolled before-and-after design.

What was found: Most studies had unclear or high risk of bias.

Patient or provider education and guideline or clinical pathway implementation were the most frequently reported interventions.

The impact of interventions showed variable results but some benefits of antimicrobial stewardship programmes may include improvement in delivery of care, a decrease in antimicrobial use, and better adherence to guidelines.

What’s uncertain: Although antimicrobial stewardship programmes in emergency departments may improve patient care, the optimal intervention or combination of interventions is uncertain.

There were few studies of audit and feedback as an antimicrobial stewardship intervention in emergency departments, so the effects of this intervention are uncertain.

No study evaluated preauthorization of antimicrobial use in emergency departments, so the effects of this intervention are uncertain.


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