The Society for Healthcare Epidemiology of America (SHEA) White Paper addressing research needs in antibiotic stewardship identifies four major categories of research gaps:
Clinical evidence to define optimal antibiotic use
- Well-designed studies to determine whether all mild to moderate community acquired pneumonia requires antibiotic therapy
- Research focusing on the sensitivity and specificity of UTI symptoms to reduce antibiotic use for asymptomatic bacteriuria
- Studies evaluating the optimal treatment duration of skin and soft tissue infections
- Research on the role of antibiotic prophylaxis for recurrent UTIs
Antibiotic stewardship implementation
- Evaluating which combinations of strategies are most effective for hospital-based antibiotic stewardship programs
- Evaluating the utility of ASPs in the emergency department
- Evaluating sustainability of stewardship interventions
- Evaluating effective ways to train healthcare personnel to support stewardship activities
- Quantification of human resource needs of different stewardship strategies and their relative impact
Standardized outcome and process metrics
- defining and validating definitions for antibiotic use such as “targeted,” “de-escalated,” “appropriate,” and “adequate” therapy
- developing a core set of standardized clinical outcome variables for which stewardship studies can be appropriately designed and powered
- evaluation of post-discharge events such as acquisition of resistant pathogens, impact on intestinal bacterial diversity, unintended or avoidable ED or clinic visits, and readmissions
Antibiotic stewardship study designs and methods
- Studies should standardize antibiotic stewardship-focused process metrics and report important patient-focused outcomes as well as process and implementation metrics
- Studies should evaluate new initiatives in the context of established ongoing antibiotic ste
- Studies should standardize antibiotic stewardship-focused process metrics and report important patient-focused outcomes as well as process and implementation metrics
- Studies should evaluate new initiatives in the context of established ongoing antibiotic stewardship activities
