Implementing practice guidelines for appropriate antimicrobial usage: a systematic review

Area of Science:

• Infectious Diseases
• Health Services Research
• Pharmacology

Background:

• Antimicrobial resistance is a growing global health threat.
• Inappropriate antimicrobial use is a significant contributing factor to resistance.
• Guidelines exist to promote appropriate antimicrobial prescribing.

Purpose of the Study:

• To systematically review studies on implementing antimicrobial use guidelines.
• To identify effective implementation strategies for appropriate antimicrobial use.
• To assess the impact of these strategies on antimicrobial prescribing outcomes.

Main Methods:

• Systematic review of comparative studies from the Medline database.
• Included studies focused on guideline implementation for appropriate antimicrobial use in common infections (community- and hospital-acquired).
• Analysis incorporated treatment effects and cost estimates.

Main Results:

• Forty studies demonstrated the effectiveness of various implementation methods.
• Multifaceted implementation strategies were most successful in promoting appropriate antimicrobial use.
• Effective individual methods included academic detailing, multidisciplinary feedback, guideline adaptation, interactive sessions, and computer-assisted care.

Conclusions:

• Multifaceted approaches are key to improving appropriate antimicrobial prescribing.
• Specific interventions like academic detailing and feedback are valuable components of implementation strategies.
• Effective implementation of guidelines can help mitigate antimicrobial resistance.