A new analysis from the INSPIRE research team found that automated prompts to improve judicious use of antibiotics for hospitalized patients led to sustained reductions in the use of extended-spectrum antibiotics.
The findings were reported in a research letter in JAMA.
INSPIRE, an NIH Collaboratory Trial, consisted of 2 cluster randomized trials that used personalized clinical decision support to improve judicious antibiotic prescribing for non–critically ill hospitalized patients with abdominal or skin and soft tissue infections during the first 3 days of hospitalization. The research program also included 2 other trials, which evaluated the same intervention for hospitalized patients with pneumonia and urinary tract infection.
In the new analysis, 65% to 84% of the reductions achieved in the use of extended-spectrum antibiotics in the first 3 days of hospitalization persisted through the remainder of the hospital stay.
“These findings suggest that investing in stewardship for initial antibiotic selection, rather than primarily focusing on de-escalating antibiotics once started, would reduce unnecessary extended-spectrum antibiotics for millions of patients in US hospitals annually,” the authors wrote.
INSPIRE was supported within the NIH Pragmatic Trials Collaboratory by a grant from the National Institute of Allergy and Infectious Diseases. The primary results were reported this year in JAMA Internal Medicine and JAMA Surgery.