2025/01/01 by Paul Greidanus, Ryan Joseph LeBlanc, Dima Kabbani +8 · 1 voice
Health Professions · Immunology and Microbiology · Medicine · #Antibiotic Use and Resistance #Antibiotics Pharmacokinetics and Efficacy #Nursing Roles and Practices
paper · pdf · doi:10.1017/ash.2025.10185
openalex publication_date 2025/01/01 · openalex created_date 2025/10/21 · openalex updated_date 2026/05/21
Abstract Objective: This study aimed to compare appropriateness of restricted antimicrobial prescriptions, as assessed by antimicrobial stewardship program (ASP) prospective audit and feedback (PAF), between those ordered by medical trainees versus staff. Secondary objectives were to determine whether certain timing factors and other independent variables impacted prescription appropriateness. Design: Single center, retrospective cohort study. Setting: The University of Alberta Hospital a 700-bed tertiary care hospital in Edmonton, Canada. Participants: Prescriptions of six health-authority restricted antibiotics subject to ASP PAF between 2018 and 2023. Cases were excluded if prescriber role or prescription dates or times were unavailable. Methods: Data from a local ASP quality improvement database was extracted. Multiple logistic regression analysis was completed with adjusted odds ratios (aOR) reported. Results: A total of 3,687 restricted antibiotic prescriptions subjected to PAF were included in this study, of which 1,163 (31.5%) were assessed as not appropriately prescribed. Prescriptions written by medical trainees did not have higher odds of appropriateness compared to staff (aOR 1.09 [95% CI 0.94–1.28], P = .25). Weekend prescriptions had a reduced odds of being appropriate (aOR 0.71 [0.60–0.84], P < .0001). Through the course of the Coronavirus Disease 2019 (COVID-19) pandemic, appropriateness improved from 56.2% (prepandemic), 71.5% (peri-pandemic) to 76.9% (postpandemic). Conclusions: No differences were noted in restricted antibiotic prescription appropriateness between medical trainees and staff. Weekend prescriptions were less likely to be appropriate. Improved appropriateness over time may be multifactorial, including implementation of ASP preceding the pandemic. Further studies examining timing factors associated with appropriateness are needed.