Association Between Antimicrobial Stewardship Programs and Antibiotic Use Globally

Antimicrobial resistance continues to spread rapidly at a global scale. Little evidence exists on the association of antimicrobial stewardship programs (ASPs) with the consumption of antibiotics across health care and income settings.

To synthesize current evidence regarding the association between antimicrobial stewardship programs and the consumption of antibiotics globally. Data Sources: PubMed, Web of Science, and Scopus databases were searched from August 1, 2010, to Aug 1, 2020. Additional studies from the bibliography sections of previous systematic reviews were included. Study Selection: Original studies of the association of ASPs with antimicrobial consumption across health care and income settings. Animal and environmental studies were excluded. Data Extraction and Synthesis: Following the Preferred Reporting Items in Systematic Reviews and Meta-Analyses guideline, the pooled association of targeted ASPs with antimicrobial consumption was measured using multilevel random-effects models. The Effective Public Health Practice Project quality assessment tool was used to assess study quality. Main Outcomes and Measures: The main outcome measures were proportion of patients receiving an antibiotic prescription and defined daily doses per 100 patient-days.