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Crespo-Rivas JC, Guisado-Gil AB, Peñalva G, et al. Are antimicrobial stewardship interventions effective and safe in long-term care facilities? A systematic review and meta-analysis. Clin Microbiol Infect. 2021;27(10):1431-1438doi: 10.1016/j.cmi.2021.06.003.
Crespo-Rivas, J. C., Guisado-Gil, A. B., Peñalva, G., Rodríguez-Villodres, �. �., Martín-Gandul, C., Pachón-Ibáñez, M. E., Lepe, J. A., & Cisneros, J. M. (2021). Are antimicrobial stewardship interventions effective and safe in long-term care facilities? A systematic review and meta-analysis. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 27(10), 1431-1438. https://doi.org/10.1016/j.cmi.2021.06.003
Crespo-Rivas, Juan Carlos, et al. "Are antimicrobial stewardship interventions effective and safe in long-term care facilities? A systematic review and meta-analysis." Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases vol. 27,10 (2021): 1431-1438. doi: https://doi.org/10.1016/j.cmi.2021.06.003
Crespo-Rivas JC, Guisado-Gil AB, Peñalva G, Rodríguez-Villodres Á, Martín-Gandul C, Pachón-Ibáñez ME, Lepe JA, Cisneros JM. Are antimicrobial stewardship interventions effective and safe in long-term care facilities? A systematic review and meta-analysis. Clin Microbiol Infect. 2021 Oct;27(10):1431-1438. doi: 10.1016/j.cmi.2021.06.003. Epub 2021 Jun 10. PMID: 34118423.
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Clin Microbiol Infect. 2021 Oct;27(10):1431-1438. doi: 10.1016/j.cmi.2021.06.003. Epub 2021 Jun 10.

Are antimicrobial stewardship interventions effective and safe in long-term care facilities? A systematic review and meta-analysis.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

Juan Carlos Crespo-Rivas, Ana Belén Guisado-Gil, Germán Peñalva, Ángel Rodríguez-Villodres, Cecilia Martín-Gandul, María Eugenia Pachón-Ibáñez, José Antonio Lepe, José Miguel Cisneros

Affiliations

  1. Department of Infectious Diseases, Microbiology and Preventive Medicine, Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC/University Hospital Virgen del Rocio, Seville, Spain.
  2. Department of Infectious Diseases, Microbiology and Preventive Medicine, Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC/University Hospital Virgen del Rocio, Seville, Spain; Department of Pharmacy, University Hospital Virgen del Rocio, Seville, Spain.
  3. Department of Infectious Diseases, Microbiology and Preventive Medicine, Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC/University Hospital Virgen del Rocio, Seville, Spain. Electronic address: [email protected].

PMID: 34118423 DOI: 10.1016/j.cmi.2021.06.003

Abstract

BACKGROUND: Long-term care facilities (LTCFs) are health-care settings with high antimicrobial consumption and hence need to develop effective antimicrobial stewardship programmes (ASPs).

OBJECTIVE: To assess the effects of ASPs on care-related, clinical and ecological outcomes in LTCFs.

METHODS: Data sources were PubMed, EMBASE, CINAHL and SCOPUS. Study eligibility criteria were original research articles (controlled clinical trials or controlled before and after studies) published up to 1 October 2020. Participants were adult residents of LTCFs, residential aged-care facilities, nursing homes, veterans' homes, skilled nursing facilities and assisted living facilities for older people. Interventions included ASPs versus standard care. Outcomes assessed were antimicrobial consumption and appropriateness, infections, hospital admissions and mortality. Available data were pooled in a meta-analysis, and inconsistency between studies was evaluated using the I

RESULTS: Of the 3111 papers identified, 12 studies met the inclusion criteria. All of them analysed the impact of interventions on antimicrobial use based on consumption-related variables (n = 8) and/or percentage of inappropriate prescriptions (n = 6). Pooled data showed a mean difference of -0.47 prescriptions per 1000 resident-days in favour of ASPs (95% CI -0.87 to -0.07, I

CONCLUSIONS: ASPs appear to improve antimicrobial use in this setting without increasing hospital admissions or deaths, indicating that these programmes do not lead to under-treatment of infections. Nonetheless, further higher-quality clinical trials are required to understand the effects of ASPs in LTCFs.

PROSPERO REGISTRATION NUMBER: CRD42021225127.

Copyright © 2021 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Keywords: Antimicrobial consumption; Antimicrobial stewardship; Long-term care facilities; Meta-analysis; Systematic review

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