5 reasons providers are likely to disagree with antimicrobial stewardship recommendations

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A study, published in Infection Control & Hospital Epidemiology, examined predictors of provider disagreement with antimicrobial stewardship prospective audit and feedback recommendations.

Researchers conducted a retrospective cohort study of audits performed during the antimicrobial stewardship program from March 30, 2015, to April 17, 2017, at a freestanding children's hospital.

The antimicrobial stewardship program included audits of antimicrobial use and communicated prospective audit and feedback recommendations to the care team, with follow-up.

In all, 4,727 antimicrobial audits were performed during the study period. Around 28 percent of
prospective audit and feedback recommendations were not followed due to disagreement.

Providers were more likely to disagree with prospective audit and feedback recommendations when the patient:

• Had a gastrointestinal infection
• Had febrile neutropenia
• Had skin or soft-tissue infections
• Had been admitted for 31 to 90 days at the time of the audit

Additionally, the more years of experience an attending provider had, the more likely they were to disagree with prospective audit and feedback recommendations.

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