Antimicrobial stewardship

The goal of prescribing medical interventions is to improve patient outcomes. The challenge of inappropriate prescribing—for example, prescribing antibacterial drugs for viral illnesses, is prevalent in infectious diseases. Research shows that a third of US antibiotic prescriptions are unnecessary and this figure is up to seven in 10 prescriptions in other countries.12 This prescribing behaviour can lead to patients experiencing adverse effects for no benefit. Various organisations have proposed stewardship programmes composed of multiple interventions to address these concerns.3In a linked paper in The BMJ (doi:10.1136/bmj‑2023‑079329), Schwartz and colleagues contribute to the literature on stewardship.4 Their study is a randomised trial in over 5000 physicians who did not opt into a previous programme in Ontario, Canada, evaluating prescriptions to patients older than age 65. The intervention was a one-time letter providing information on prescribing compared with peers, with further interventions of information on case-mix adjustments and general information on harms…
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