Impact of Prospective Audit and Feedback Antimicrobial Stewardship Strategy: A Retrospective Analysis in a Tertiary...

Background Antimicrobial stewardship programs are fundamental strategies for improving prescribing practices. In Colombia, evidence of their impact is limited. Objective The objective of this study was to ascertain the role of antimicrobial therapy change, as an intervention of the antimicrobial stewardship programme, as an audit strategy, in the period from January to July 2024 in a tertiary care hospital in Colombia, Hospital Universitario San Rafael de Tunja. Methods Patients, including adults over 18 years, were evaluated through an audit-and-feedback stewardship strategy, while data analysis was retrospectively collected. Patients who died, were discharged, or were referred before the antimicrobial stewardship programme team intervention were excluded. Clinical, microbiological, and therapeutic characteristics, duration of treatment, and adherence to the antimicrobial stewardship programme's recommendations were analysed.  Results A total of 487 patients were included in the study, with a median age of 59 years and a male-to-female ratio of 53.8% to 46.2%. The primary diagnosis was urinary tract infection, accounting for 27.7% of cases. Piperacillin/tazobactam was the most commonly used empirical antimicrobial. Following the implementation of the antimicrobial stewardship programme at the hospital in January 2024, treatment was adjusted in 78.2% of cases, with de-escalation (37.8%) and stepwise escalation (37.6%) predominating. Following the interventions by the antimicrobial stewardship group, 92.2% of prescribers demonstrated overall compliance. Targeted treatment was significantly shorter in patients who underwent intervention (median: 5 days) compared to those who did not (7 days; p < 0.001). The 30-day readmission rate was 19.1%, with no significant differences between groups. Conclusions The implementation of antimicrobial stewardship programmes enabled the optimisation of antimicrobial therapy through individualised adjustments, achieving high adherence and a reduction in treatment duration, supporting the role of antimicrobial stewardship programmes as a key strategy for improving prescription quality. However, prospective studies are needed to evaluate its long-term clinical, microbiological, and economic impact.