Intervention Review

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Interventions to improve antibiotic prescribing practices for hospital inpatients

  1. Peter Davey1,*,
  2. Erwin Brown2,
  3. Esmita Charani3,
  4. Lynda Fenelon4,
  5. Ian M Gould5,
  6. Alison Holmes6,
  7. Craig R Ramsay7,
  8. Philip J Wiffen8,
  9. Mark Wilcox9

Editorial Group: Cochrane Effective Practice and Organisation of Care Group

Published Online: 30 APR 2013

Assessed as up-to-date: 3 FEB 2009

DOI: 10.1002/14651858.CD003543.pub3


How to Cite

Davey P, Brown E, Charani E, Fenelon L, Gould IM, Holmes A, Ramsay CR, Wiffen PJ, Wilcox M. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD003543. DOI: 10.1002/14651858.CD003543.pub3.

Author Information

  1. 1

    University of Dundee, Population Health Sciences Division, Medical Research Institute, Dundee, Scotland, UK

  2. 2

    Bristol, UK

  3. 3

    Imperial College London, The National Centre for Infection Prevention and Management, London, UK

  4. 4

    St Vincent's University Hospital, Department of Microbiology, Dublin 4, Republic of Ireland, Ireland

  5. 5

    Aberdeen Royal Infirmary, Department of Medical Microbiology, Aberdeen, UK

  6. 6

    Imperial College of Science, Technology and Medicine, Department of Infectious Diseases and Microbiology, London, UK

  7. 7

    University of Aberdeen, Health Services Research Unit, Division of Applied Health Sciences, Aberdeen, UK

  8. 8

    University of Oxford, Pain Research and Nuffield Department of Clinical Neurosciences, Oxford, Oxfordshire, UK

  9. 9

    University of Leeds, Department of Microbiology, Leeds, UK

*Peter Davey, Population Health Sciences Division, Medical Research Institute, University of Dundee, Mackenzie Building, Kirsty Semple Way, Dundee, Scotland, DD2 4BF, UK. p.g.davey@dundee.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 30 APR 2013

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Abramowitz 1982 {published data only}
  • Abramowitz PW, Nold EG, Hatfield SM. Use of clinical pharmacists to reduce cefamandole, cefoxitin and ticarcillin costs. American Journal of Hospital Pharmacy 1982;39:1176-80.
Adachi 1997 {published data only}
  • Adachi W, Bolding F, Armstrong R. Experience with vancomycin education and order sheet to limit vancomycin use. Hospital Pharmacy 1997;32:1370-3.
Ansari 2003 {published data only}
  • Ansari F, Gray K, Nathwani D, Phillips G, Ogston S, Ramsay C, et al. Outcomes of an intervention to improve hospital antibiotic prescribing: interrupted time series with segmented regression analysis. Journal of Antimicrobial Chemotherapy 2003;52(5):842-8.
Avorn 1988 {published data only}
  • Avorn J, Soumerai SB, Taylor W, Wessels MR, Janousek J, Weiner M. Reduction of incorrect antibiotic dosing through a structured educational order form. Archives of Internal Medicine 1988;148:1720-4.
Bailey 1997 {published data only}
  • Bailey TC, Ritchie DJ, McMullin ST, Kahn M, Reichley RM, Casabar E, et al. A randomized, prospective evaluation of an interventional program to discontinue intravenous antibiotics at two tertiary care teaching institutions. Pharmacotherapy 1997;17(2):277-81.
Barlow 2007 {published data only}
  • Barlow G, Nathwani D, Williams F, Ogston S, Winter J, Jones M, et al. Reducing door-to-antibiotic time in community-acquired pneumonia: Controlled before-and-after evaluation and cost-effectiveness analysis. Thorax 2007;62(1):67-74.
Belliveau 1996 {published data only}
  • Belliveau PP, Rothman AL, Maday CE. Limiting vancomycin use to combat vancomycin-resistant Enterococcus faecium. American Journal of Health-System Pharmacy 1996;53(13):1570-5.
Berild 2002 {published data only}
  • Berild D, Ringertz SH, Aabyholm G, Lelek M, Fosse B. Impact of an antibiotic policy on antibiotic use in a paediatric department. Individual based follow-up shows that antibiotics were chosen according to diagnoses and bacterial findings. International Journal of Antimicrobial Agents 2002;20:333-8.
Borer 2004 {published data only}
Bouza 2004 {published data only}
  • Bouza E, Sousa D, Munoz P, Rodriguez-Creixems M, Fron C, Lechuz J G. Bloodstream infections: a trial of the impact of different methods of reporting positive blood culture results. Clinical Infectious Diseases 2004;39(8):1161-9.
Bradley 1999 {published data only}
  • Bradley SJ, Wilson ALT, Allen MC, Sher HA, Goldstone AH, Scott GM. The control of hyperendemic glycopeptide-resistant Enterococcus spp. on a haematology unit by changing antibiotic usage. Journal of Antimicrobial Chemotherapy 1999;43(2):261-6.
Bruins 2005 {published data only}
  • Bruins M, Oord H, Bloembergen P, Wolfhagen M, Casparie A, Degener J, et al. Lack of effect of shorter turnaround time of microbiological procedures on clinical outcomes: a randomised controlled trial among hospitalised patients in the Netherlands. European Journal of Clinical Microbiology and Infectious Diseases 2005;24(5):305-13.
Bunz 1990 {published data only}
Burton 1991 {published data only}
Calil 2001 {published data only}
  • Calil R, Marba ST, Von Nowakonski A, Tresoldi AT. Reduction in colonization and nosocomial infection by multiresistant bacteria in a neonatal unit after institution of educational measures and restriction in the use of cephalosporins. American Journal of Infection Control 2001;29(3):133-8.
Carling 2003 {published data only}
  • Carling P, Fung T, Killion A, Terrin N, Barza M. Favorable impact of a multidisciplinary antibiotic management program conducted during 7 years. Infection Control and Hospital Epidemiology 2003;24(9):699-706.
Charbonneau 2006 {published data only}
  • Charbonneau P, Parienti J J, Thibon P, Ramakers M, Daubin C, du Cheyron D, et al. Fluoroquinolone use and methicillin-resistant Staphylococcus aureus isolation rates in hospitalized patients: a quasi experimental study. Clinical Infectious Diseases 2006;42(6):778-84.
Christ-Crain 2004 {published data only}
  • Christ-Crain M, Jaccard-Stolz D, Bingisser R, Gencay MM, Huber PR, Tamm M, et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet 2004;363(9409):600-7.
Christ-Crain 2006 {published data only}
  • Christ-Crain M, Stolz D, Bingisser R, Muller C, Miedinger D, Huber P R, et al. Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia: a randomized trial. American Journal of Respiratory and Critical Care Medicine 2006;174(1):84-93.
Chu 2003 {published data only}
  • Chu LA, Bratzler DW, Lewis RJ, Murray C, Moore L, Shook C, et al. Improving the quality of care for patients with pneumonia in very small hospitals. Archives of Internal Medicine 2003;163(3):326-32.
Climo 1998 {published data only}
  • Climo MW, Israel DS, Wong ES, Williams D, Coudron P, Markowitz SM. Hospital-wide restriction of clindamycin: effect on the incidence of Clostridium difficile-associated diarrhea and cost. Annals of Internal Medicine 1998;128(12 Pt 1):989-95.
Dean 2001 {published data only}
  • Dean NC, Silver MP, Bateman KA, James B, Hadlock CJ, Hale D. Decreased mortality after implementation of a treatment guideline for community-acquired pneumonia. American Journal of Medicine 2001;110(6):451-7.
Dean 2006 {published data only}
de Champs 1994 {published data only}
  • de Champs C, Franchineau P, Gourgand JM, Loriette Y, Gaulme J, Sirot J. Clinical and bacteriological survey after change in aminoglycoside treatment to control an epidemic of Enterobacter cloacae. Journal of Hospital Infection 1994;28(3):219-29.
de Man 2000 {published data only}
Dempsey 1995 {published data only}
Doern 1994 {published data only}
  • Doern GV, Vautour R, Gaudet M, Levy B. Clinical impact of rapid in vitro susceptibility testing and bacterial identification. Journal of Clinical Microbiology 1994;32(7):1757-62.
Dranitsaris 2001 {published data only}
  • Dranitsaris G, Spizzirri D, Pitre M, McGeer A. A randomized trial to measure the optimal role of the pharmacist in promoting evidence-based antibiotic use in acute care hospitals. International Journal of Technology Assessment in Health Care 2001;17(2):171-80.
Everitt 1990 {published data only}
  • Everitt DE, Soumerai SB, Avorn J, Klapholz H, Wessels M. Changing surgical antimicrobial prophylaxis practices through education targeted at senior department leaders. Infection Control and Hospital Epidemiology 1990;11(11):578-83.
Fine 2003 {published data only}
  • Fine MJ, Stone RA, Lave JR, Hough LJ, Obrosky DS, Mor MK, et al. Implementation of an evidence-based guideline to reduce duration of intravenous antibiotic therapy and length of stay for patients hospitalized with community-acquired pneumonia: a randomized controlled trial. American Journal of Medicine 2003;115(5):343-51.
Foy 2004 {published data only}
  • Foy R, Penney GC, Grimshaw JM, Ramsay CR, Walker AE, MacLennan G, et al. A randomised controlled trial of a tailored multifaceted strategy to promote implementation of a clinical guideline on induced abortion care. British Journal of Obstetrics and Gynaecology 2004;111(7):726-33.
Franz 2004 {published data only}
  • Franz AR, Bauer K, Schalk A, Garland SM, Bowman ED, Rex K, et al. Measurement of interleukin 8 in combination with C-reactive protein reduced unnecessary antibiotic therapy in newborn infants: a multicenter, randomized, controlled trial. Pediatrics 2004;114(1):1-8.
Fraser 1997 {published data only}
  • Fraser GL, Stogsdill P, Dickens JD, Wennberg DE, Smith RP, Prato S. Antibiotic opitimization: an evaluation of patient safety and economic outcomes. Archives of Internal Medicine 1997;157:1689-94.
Fridkin 2002 {published data only}
  • Fridkin SK, Lawton R, Edwards JR, Tenover FC, McGowan JE Jr, Gaynes RP. Monitoring antimicrobial use and resistance: comparison with a national benchmark on reducing vancomycin use and vancomycin-resistant enterococci. Emerging Infectious Diseases 2002;8(7):702-7.
Gerding 1985 {published data only}
  • Gerding DN, Larson TA. Aminoglycoside resistance in gram-negative bacilli during increased amikacin use. Comparison of experience in 14 United States hospitals with experience in the Minneapolis Veterans Administration Medical Center. American Journal of Medicine 1985;79(1A):1-7.
Gums 1999 {published data only}
Gupta 1989 {published data only}
  • Gupta S, Bachand RL, Jewesson PJ. Impact of a two-stage intervention program on cefazolin usage at a major teaching hospital. Hospital Formulary 1989;24(1):41-4, 46.
Halm 2004 {published data only}
  • Halm EA, Horowitz C, Silver A, Fein A, Dlugacz YD, Hirsch B, et al. Limited impact of a multicenter intervention to improve the quality and efficiency of pneumonia care. Chest 2004;126(1):100-7.
Hess 1990 {published data only}
  • Hess DA, Mahoney CD, Johnson PN, Corrao WM, Fisher A. Integration of clinical and administrative strategies to reduce expenditures for antimicrobial agents. American Journal of Hospital Pharmacy 1990;47:585-91.
Himmelberg 1991 {published data only}
  • Himmelberg CJ, Pleasants RA, Weber DJ, Kessler JM, Samsa GP, Spivey JM, et al. Use of antimicrobial drugs in adults before and after removal of a restriction policy. American Journal of Public Health 1991;48:1220-7.
Huber 1982 {published data only}
Hulgan 2004 {published data only}
Inaraja 1986 {published data only}
  • Inaraja MT, Paloma JM, Giraldez J, Idoate AJ, Hualde S. Computer-assisted antimicrobial-use monitoring. American Journal of Hospital Pharmacy 1986;43:664-70.
Khan 2003 {published data only}
  • Khan R, Cheesbrough J. Impact of changes in antibiotic policy on Clostridium difficile-associated diarrhoea (CDAD) over a five-year period in a district general hospital. Journal of Hospital Infection 2003;54(2):104-8.
Kumana 2001 {published data only}
Landgren 1988 {published data only}
  • Landgren FT, Harvey KJ, Mashford ML, Moulds RFW, Guthrie B, Hemming M. Changing antibiotic prescribing by educational marketing. The Medical Journal of Australia 1988;149:595-9.
Landman 1999 {published data only}
  • Landman D, Chockalingam M, Quale JM. Reduction in the incidence of methicillin-resistant Staphylococcus aureus and ceftazidime-resistant Klebsiella pneumoniae following changes in a hospital antibiotic formulary. Clinical Infectious Diseases 1999;28(5):1062-6.
Lautenbach 2003 {published data only}
  • Lautenbach E, LaRosa LA, Marr AM, Nachamkin I, Bilker WB, Fishman NO. Changes in the prevalence of vancomycin-resistant enterococci in response to antimicrobial formulary interventions: impact of progressive restrictions on use of vancomycin and third-generation cephalosporins. Clinical Infectious Diseases 2003;36(4):440-6.
Lee 1995 {published data only}
Leverstein 2001 {published data only}
  • Leverstein-van Hall MA, Fluit AC, Blok HE, Box AT, Peters ED, Weersink AJ, et al. Control of nosocomial multiresistant Enterobacteriaceae using a temporary restrictive antibiotic agent policy. European Journal of Clinical Microbiology and Infectious Diseases 2001;20:785-91.
Madaras-Kelly 2006 {published data only}
  • Madaras-Kelly KJ, Remington RE, Lewis PG, Stevens DL. Evaluation of an intervention designed to decrease the rate of nosocomial methicillin-resistant Staphylococcus aureus infection by encouraging decreased fluoroquinolone use. Infection Control and Hospital Epidemiology 2006;27(2):155-69.
May 2000 {published data only}
  • May AK, Melton SM, McGwin G, Cross JM, Moser SA, Rue LW. Reduction of vancomycin-resistant enterococcal infections by limitation of broad-spectrum cephalosporin use in a trauma and burn intensive care unit. Shock 2000;14(3):259-64.
McElnay 1995 {published data only}
  • McElnay JC, Scott MG, Sidara JY, Kearney P. Audit of antibiotic usage in medium-sized general hospital over an 11-year period. The impact of antibiotic policies. Pharmacy World and Science 1995;17(6):207-13.
McGowan 1976 {published data only}
McLaughlin 2005 {published data only}
  • McLaughlin CM, Bodasing N, Boyter AC, Fenelon C, Fox JG, Seaton RA. Pharmacy-implemented guidelines on switching from intravenous to oral antibiotics: an intervention study. Quarterly Journal of Medicine 2005;98(10):745-52.
McNulty 1997 {published data only}
  • McNulty C, Logan M, Donald IP, Ennis D, Taylor D, Baldwin RN, et al. Successful control of Clostridium difficile infection in an elderly care unit through use of a restrictive antibiotic policy. Journal of Antimicrobial Chemotherapy 1997;40:707-11.
Mercer 1999 {published data only}
  • Mercer KA, Chintalapudi SR, Visconti EB. Impact of targeted antibiotic restriction on usage and cost in a community hospital. Journal of Pharmacy Technology 1999;15:79-84.
Meyer 1993 {published data only}
Micek 2004 {published data only}
  • Micek ST, Ward S, Fraser VJ, Kollef MH. A randomized controlled trial of an antibiotic discontinuation policy for clinically suspected ventilator-associated pneumonia. Chest 2004;125(5):1791-9.
Mol 2005 {published data only}
  • Mol PGM, Wieringa JE, Nannan Panday PV, Gans ROB, Degener JE, Laseur M, et al. Improving compliance with hospital antibiotic guidelines: a time-series intervention analysis. Journal of Antimicrobial Chemotherapy 2005;55(4):550-7.
Naughton 2001 {published data only}
Oosterheert 2005 {published data only}
  • Oosterheert JJ, Van Loon AM, Schuurman R, Hoepelman AI, Hak E, Thijsen S, et al. Impact of rapid detection of viral and atypical bacterial pathogens by real-time polymerase chain reaction for patients with lower respiratory tract infection. Clinical Infectious Diseases 2005;41(10):1438-44.
Patel 1989 {published data only}
  • Patel M, Jackson C. Targeted interventions on oral antibiotic expenditure. British Journal of Pharmaceutical Practice 1989;11:306-8.
Paul 2006 {published data only}
  • Paul M, Andreassen S, Tacconelli E, Nielsen AD, Almanasreh N, Frank U, et al. Improving empirical antibiotic treatment using TREAT, a computerized decision support system: cluster randomized trial. Journal of Antimicrobial Chemotherapy 2006;58(6):1238-45.
Pear 1994 {published data only}
  • Pear SM, Williamson TH, Bettin KM, Gerding DN, Galgiani JN. Decrease in nosocomial Clostridium difficile-associated diarrhea by restricting clindamycin use. Annals of Internal Medicine 1994;120(4):272-7.
Perez 2003 {published data only}
  • Perez A, Dennis RJ, Rodriguez B, Castro AY, Delgado V, Lozano JM, et al. An interrupted time series analysis of parenteral antibiotic use in Colombia. Journal of Clinical Epidemiology 2003;56(10):1013-20.
Richards 2003 {published data only}
  • Richards MJ, Robertson MB, Dartnell JG, Duarte MM, Jones NR, Kerr DA, et al. Impact of a web-based antimicrobial approval system on broad-spectrum cephalosporin use at a teaching hospital. Medical Journal of Australia 2003;178:386-90.
Richardson 2000 {published data only}
  • Richardson LP, Wiseman SW, Melani PN, Lyons MJ, Kauffman CA. Effectiveness of a vancomycin restriction policy in changing the prescribing patterns of house staff. Microbial Drug Resistance 2000;6(4):327-30.
Saizy-Callaert 2003 {published data only}
  • Saizy-Callaert S, Causse R, Furhman C, Le Paih MF, Thebault A, Chouaid C. Impact of a multidisciplinary approach to the control of antibiotic prescription in a general hospital. Journal of Hospital Infection 2003;53(3):177-82.
Salama 1996 {published data only}
  • Salama S, Rotstein C, Mandell L. A multidisciplinary hospital-based antimicrobial use program: impact on hospital pharmacy expenditures and drug use. Canadian Journal of Infectious Diseases 1996;7:104-9.
Senn 2004 {published data only}
  • Senn L, Burnand B, Francioli P, Zanetti G. Improving appropriateness of antibiotic therapy: randomized trial of an intervention to foster reassessment of prescription after 3 days. Journal of Antimicrobial Chemotherapy 2004;53(6):1062-7.
Shojania 1998 {published data only}
  • Shojania KG, Yokoe D, Platt R, Fiskio J, Ma'luf N, Bates DW. Reducing vancomycin use utilizing a computer guideline: results of a randomized controlled trial. Journal of the American Medical Informatics Association 1998;5(6):554-62.
Singh 2000 {published data only}
  • Singh N, Rogers P, Atwood CW, Wagener MM, Yu VL. Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription. American Journal of Respiratory and Critical Care Medicine 2000;162(2 Pt 1):505-11.
Sirinavin 1998 {published data only}
  • Sirinavin S, Suvanakoot P, Sathapatayavongs B, Malatham K. Effect of antibiotic order form guiding rational use of expensive drugs on cost containment. Southeast Asian Journal of Tropical Medicine and Public Health 1998;29(3):636-42.
Skaer 1993 {published data only}
  • Skaer TL, Sclar DA, Won JKH, Markowski DJ. Effect of academic detailing on the utilization of intravenous antimicrobial therapy. Current Therapeutic Research 1993;53(4):349-55.
Solomon 2001 {published data only}
  • Solomon DH, Van Houten L, Glynn RJ, Baden L, Curtis K, Schrager H, Avorn J. Academic detailing to improve use of broad-spectrum antibiotics at an academic medical center. Archives of Internal Medicine. 2001;161(15):1897-902.
Stevenson 1988 {published data only}
  • Hampson JP, Corkhill JE, Murray A, Griffiths LR, Smith JC, Bartzokas CA. Potential financial benefits of a local antibiotic policy. Pharmaceutical Journal 1988;241:660-2.
  • Stevenson RC, Blackman SC, Williams CL, Bartzokas CA. Measuring the saving attributable to an antibiotic prescribing policy. Journal of Hospital Infection 1988;11:16-25.
Suwangool 1991 {published data only}
  • Suwangool P, Moola-Or P, Waiwatana A, Sitthi-amorn C, Israsena S, Hanvanich M. Effect of a selective restriction policy on antibiotic expenditure and use: an institutional model. Journal of the Medical Association of Thailand 1991;74:272-5.
Toltzis 1998 {published data only}
  • Toltzis P, Yamashita T, Vilt L, Green M, Morrissey A, Spinner-Block S, et al. Antibiotic restriction does not alter endemic colonization with resistant gram-negative rods in a pediatric intensive care unit. Critical Care Medicine 1998;26(11):1893-9.
Toltzis 2002 {published data only}
  • Toltzis P, Dul MJ, Hoyen C, Salvator A, Walsh M, Zetts L, et al. The effect of antibiotic rotation on colonization with antibiotic-resistant bacilli in a neonatal intensive care unit. Pediatrics 2002;110:707-11.
Trenholme 1989 {published data only}
  • Trenholme GM, Kaplan RL, Karakusis PH, Stine T, Fuhrer J, Landau W, et al. Clinical Impact of Rapid Identification and Susceptibility Testing of Bacterial Blood Culture Isolates. Journal of Clinical Microbiology 1989;27(6):1342-5.
Van Kasteren 2005 {published data only}
  • Van Kasteren ME, Mannien J, Kullberg BJ, de Boer AS, Nagelkerke NJ, Ridderhof M, et al. Quality improvement of surgical prophylaxis in Dutch hospitals: evaluation of a multi-site intervention by time series analysis. Journal of Antimicrobial Chemotherapy 2005;56(6):1094-102.
Walker 1998 {published data only}
  • Walker SE. Physicians' acceptance of a preformatted pharmacy intervention chart note in a community hospital antibiotic step down program. Journal of Pharmacy Technology 1998;14:141-5.
Weinberg 2001 {published data only}
  • Weinberg M, Fuentes JM, Ruiz A I, Lozano FW, Angel E, Gaitan H, et al. Reducing infections among women undergoing cesarean section in Colombia by means of continuous quality improvement methods. Archives of Internal Medicine 2001;161(19):2357-65.
Wilson 1991 {published data only}
  • Wilson J, Gordon A, French S, Aslam M. The effectiveness of prescribers newsletters in influencing hospital drug expenditure. Hospital Pharmacy Practice 1991;1:33-8.
Woodward 1987 {published data only}
  • Woodward RS, Medoff G, Smith MD, Gray JLI. Antibiotic cost savings from formulary restrictions and physician monitoring in a medical-school-affiliated hospital. American Journal of Medicine 1987;83(5):817-23.
Wyatt 1998 {published data only}
  • Wyatt JC, Paterson-Brown S, Johanson R, Altman DG, Bradburn MJ, Fisk NM. Randomised trial of educational visits to enhance use of systematic reviews in 25 obstetric units. BMJ 1998;317(7165):1041-6.
Young 1985 {published data only}
Zanetti 2003 {published data only}
  • Zanetti G, Flanagan HL Jr, Cohn LH, Giardina R, Platt R. Improvement of intraoperative antibiotic prophylaxis in prolonged cardiac surgery by automated alerts in the operating room. Infection Control and Hospital Epidemiology 2003;24:13-6.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Ahronheim 2000 {published data only}
  • Ahronheim JC, Morrison RS, Morris J, Baskin S, Meier DE. Palliative care in advanced dementia: a randomized controlled trial and descriptive analysis. Journal of Palliative Medicine 2000; Vol. 3, issue 3:265-73.
Bruno-Murtha 2005 {published data only}
Burke 1997 {published data only}
  • Burke CE, Piper J, Holloway W. Order form for restricting vancomycin prescribing. American Journal of Health-System Pharmacy 1997;54(16):1893, 1897.
Cook 2006 {published data only}
  • Cook PP, Catrou P, Gooch M, Holbert D. Effect of reduction in ciprofloxacin use on prevalence of meticillin-resistant Staphylococcus aureus rates within individual units of a tertiary care hospital. Journal of Hospital Infection 2006;64:348-51.
Crist 1987 {published data only}
Dellinger 2005 {published data only}
  • Dellinger EP, Hausmann SM, Bratzler DW, Johnson RM, Daniel DM, Bunt KM, et al. Hospitals collaborate to decrease surgical site infections. American Journal of Surgery 2005;190(1):9-15.
Destache 1990 {published data only}
  • Destache CJ, Meyer SK, Bittner MJ, Hermann KG. Impact of a clinical pharmacokinetic service on patients treated with aminoglycosides: a cost-benefit analysis. Therapeutic Drug Monitoring 1990;12(5):419-26.
Ehrenkranz 1992 {published data only}
  • Ehrenkranz NJ, Nerenberg DE, Shultz JM, Slater KC. Intervention to discontinue parenteral antimicrobial therapy in patients hospitalized with pulmonary infections: effect on shortening patient stay. Infection Control and Hospital Epidemiology 1992;13(1):21-32.
Ehrenkranz 1993 {published data only}
  • Ehrenkranz NJ, Nerenberg DE, Slater KC, Shultz JM. Intervention to discontinue parenteral antimicrobial therapy in hospitalized patients with urinary tract infection, skin and soft tissue infection, or no evident infection. Infection Control and Hospital Epidemiology 1993;14(9):517-22.
Evans 1994 {published data only}
Gerding 1991 {published data only}
  • Gerding DN, Larson TA, Hughes RA, Weiler M, Shanholtzer C, Peterson LR. Aminoglycoside resistance and aminoglycoside usage: ten years of experience in one hospital. Antimicrobial Agents and Chemotherapy 1991;35(7):1284-90.
Hampson 1988 {published data only}
  • Hampson JP, Corkhill JE, Murray A, Griffiths LR, Smith JC, Bartzokas CA. Potential financial benefits of a local antibiotic policy. Pharmaceutical Journal 1988:660-2.
Kolar 1999 {published data only}
Lan 2003 {published data only}
  • Lan CK, Hsueh PR, Wong WW, Fung CP, Lau YT, Yeung JY, et al. Association of antibiotic utilization measures and reduced incidence of infections with extended-spectrum beta-lactamase-producing organisms. Journal of Microbiology, Immunology, and Infection 2003;36(3):182-6.
Lee 2004 {published data only}
  • Lee SO, Lee ES, Park SY, Kim SY, Seo YH, Cho YK. Reduced use of third-generation cephalosporins decreases the acquisition of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae. Infection Control and Hospital Epidemiology 2004;25(10):832-7.
MacCosbe 1985 {published data only}
  • MacCosbe PE, Gartenberg G. Modifying empiric antibiotic prescribing: experience with one strategy in a medical residency program. Hospital Formulary 1985;20(9):986-5, 999.
Marrie 2000 {published data only}
  • Marrie TJ, Lau CY, Wheeler SL, Wong CJ, Vandervoort MK, Feagan BG. A controlled trial of a critical pathway for treatment of community- acquired pneumonia. CAPITAL Study Investigators. Community-Acquired Pneumonia Intervention Trial Assessing Levofloxacin. Journal of the American Medical Association 2000;283(6):749-55.
Martin 2005 {published data only}
  • Martin C, Ofotokun I, Rapp R, Empey K, Armitstead J, Pomeroy C, et al. Results of an antimicrobial control program at a university hospital. American Journal of Health-System Pharmacy 2005;62(7):732-8.
McGowan 1974 {published data only}
  • McGowan JE, Findland M. Usage of antibiotics in a general hospital: Effect of requiring justification. Journal of Infectious Diseases 1974; Vol. 130, issue 2:165-8.
McGregor 2006 {published data only}
  • McGregor JC, Weekes E, Forrest GN, Standiford HC, Perencevich EN, Furuno JP, et al. Impact of a computerized clinical decision support system on reducing inappropriate antimicrobial use: a randomized controlled trial. Journal of the American Medical Informatics Association 2006;13(4):378-84.
Palmer 2000 {published data only}
  • Palmer CS, Zhan C, Elixhauser A, Halpern MT, Rance L, Feagan BG, et al. Economic assessment of the community-acquired pneumonia intervention trial employing levofloxacin. Clinical Therapeutics 2000; Vol. 22, issue 2:250-64.
Pastel 1992 {published data only}
  • Pastel DA, Chang S, Nessim S, Shane R, Morgan MA. Department of pharmacy-initiated program for streamlining empirical antibiotic therapy. Hospital Pharmacy 1992;27(7):596-603, 614.
Ronning 1998 {published data only}
Sanazaro 1978 {published data only}
  • Sanazaro PJ, Worth RM. Concurrent quality assurance in hospital care. Report of a study by private initiative in PSRO. New England Journal of Medicine 1978; Vol. 298, issue 21:1171-7.
Thomas 2002 {published data only}
  • Thomas AR, Cieslak PR, Strausbaugh LJ, Fleming DW. Effectiveness of pharmacy policies designed to limit inappropriate vancomycin use: a population-based assessment. Infection Control and Hospital Epidemiology 2002;23(11):683-8.
Tiley 2003 {published data only}
  • Tiley SM, MacDonald JJ, Doherty PL, Ferguson JK, Fergusson JE. Active promotion of antibiotic guidelines: an intensive program. Communicable Disease Intelligence 2003; Vol. 27 Suppl:13-8.
Tsiata 2001 {published data only}
  • Tsiata C, Tsekouras V, Karokis A, Starakis J, Bassaris HP, Maragoudakis M, et al. Cost effectiveness of antibacterial restriction strategies in a tertiary care university teaching hospital. Disease Management and Health Outcomes 2001;9:23-32.
Van Loon 2005 {published data only}
  • Van Loon HJ, Vriens MR, Fluit AC, Troelstra A, Van der Werken C, Verhoef J, et al. Antibiotic rotation and development of gram-negative antibiotic resistance. American Journal of Respiratory and Critical Care Medicine 2005;171(5):480-7.
Wahlstrom 2003 {published data only}
  • Wahlstrom R, Kounnavong S, Sisounthone B, Phanyanouvong A, Southammavong T, Eriksson B, et al. Effectiveness of feedback for improving case management of malaria, diarrhoea and pneumonia--a randomized controlled trial at provincial hospitals in Lao PDR. Tropical Medicine and International Health 2003;8(10):901-9.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
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Amadeo 2010
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Arnold 2005
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LaRosa 2007
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Martinez 2006
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McGowan 2012
Michie 2009
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References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Davey 2005
  • Davey P, Brown E, Fenelon L, Finch R, Gould I, Hartman G, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database of Systematic Reviews 2005, Issue 4. [DOI: 10.1002/14651858.CD003543.pub2]