Comparative Analysis of antimicrobial stewardship programs versus Standard Care in nosocomial infection
DOI:
https://doi.org/10.5281/zenodo.22812866Keywords:
antimicrobial stewardship, nosocomial infection, standard care, antimicrobial resistance, hospital-acquired infectionAbstract
Background: Antimicrobial stewardship programs (ASPs) optimize antimicrobial selection, dosing, and duration while curbing the selective pressure that sustains multidrug-resistant organisms [1,2].
Objective: This analysis synthesizes evidence contrasting ASPs with standard, non-stewarded care in nosocomial infection, across use, resistance, Clostridioides difficile infection, length of stay, cost, and mortality.
Methods: We synthesized IDSA/SHEA guidance, policy frameworks, systematic reviews and meta-analyses, and comparative intervention studies addressing stewardship-supported versus standard prescribing for nosocomial infection.
Findings: Stewardship produced large reductions in inappropriate use and expenditure [9,13], a pooled ~50% reduction in C. difficile incidence [11], and no rigorous evidence of harm to mortality [14,25].
Conclusions: ASPs outperform standard care across outcome domains, with benefit tracking program intensity; multimodal strategies combining audit-and-feedback, preauthorization, and rapid-diagnostics-linked de-escalation should be prioritized over education-only models [2,15].
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