Prospective Audit and Feedback by Antibiotic Stewardship Teams to Reduce Antibiotic Overuse at Hospital Discharge

Does a discharge-focused prospective audit and feedback process decrease antibiotic overuse at hospital discharge?In this stepped-wedge cluster-randomized clinical trial across participating units at 10 hospitals with 21 842 admissions, the frequency and duration of antibiotic prescribing at hospital discharge did not decrease after implementing a prospective audit and feedback process. However, in selected patients with uncomplicated infections, optimal antibiotic-prescribing increased once the intervention went into effect.Discharge-focused prospective audit and feedback was not effective in reducing general antibiotic overuse at hospital discharge, but it did improve antibiotic prescribing in a subset of patients, suggesting that other strategies are needed to prevent unnecessary antibiotic use at this transition of care.

Corresponding Author: Daniel J. Livorsi, MD, MSc, Department of Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242 (daniel-livorsi@uiowa.edu).

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