In a secondary analysis of data from the INSPIRE trials, an antibiotic stewardship program that included automated prompts to deliver patient-specific risk information to clinicians led to significant reductions in the use of extended-spectrum antibiotics in patients with cancer who were hospitalized with infection. The analysis extends the findings of INSPIRE to a population of patients for whom judicious antibiotic prescribing is especially important.
The findings were published online in JAMA Network Open.
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 new analysis used data from the 2 NIH Collaboratory trials, plus 2 other trials in the INSPIRE program in patients with pneumonia or urinary tract infection. The findings further support a pragmatic, scalable strategy for improving antimicrobial use in a patient population with limited evidence to guide antibiotic stewardship.
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 last year in JAMA Internal Medicine and JAMA Surgery.