Enhancing antimicrobial stewardship through IT-enabled audits: a quasi-experimental study in urology

Antimicrobial stewardship programs (ASPs) are critical for optimizing antibiotic use and addressing antimicrobial resistance (AMR). Urinary tract infections (UTIs) frequently require antibiotics, yet inappropriate prescribing remains high.

To assess how a structured audit process, supported by information technology (IT), influences antibiotic prescribing practices for UTIs in the Urology Department at Prime Hospital.

A 12-month quasi-experimental study was conducted in two phases: preintervention and intervention. A customized module in the electronic medical record (EMR) system monitored UTI prescriptions. Alerts for restricted antibiotics were reviewed daily by the antimicrobial stewardship (AMS) team, with immediate feedback to prescribers. The audit emphasized adherence to empirical guidelines, reducing fluoroquinolone use, promoting Access group antibiotics, and minimizing restricted agents.

All adult UTI patients in the Urology Department were included; pediatric patients under 12 and pregnant women were excluded.

The intervention improved guideline adherence increased the use of Access group antibiotics and reduced restricted antibiotic prescriptions by approximately 50%. Daily multidisciplinary feedback reinforced rational prescribing; however, sustaining long-term behavioral change remained challenging.

Despite growing awareness of AMR, inappropriate antibiotic use persists. IT-enabled audits, combined with multidisciplinary collaboration, effectively enhance guideline adherence, promote rational antibiotic use, and improve patient care outcomes in hospital-based UTI management.