Intensive specialists’ consultation combined with antibiotic stewardship programmes

Abstract

Abstract Background Antibiotic Stewardship Programmes (ASP) combine measures to optimise antibiotic (AB) therapies and ensure high AB prescription quality. Studies have shown that ASP in combination with an infectious disease (ID) consultation, can significantly improve the rational use of AB. This study aims to improve the quality of care and treatment of ID patients after implementing ASP activities, with or without ID consultation. Methods This is a study protocol of a prospective, two-arm, clustered intervention study with before-after-analyses conducted in ten hospitals (excl. university hospitals) in Germany over a period of three years. The intervention includes the implementation of ASP, with or without consultation by an ID specialist. We will gather information on ID inpatients (diagnosed with community-acquired pneumonia (CAP) N = 335 and Staphylococcus aureus bacteraemia (SAB) N = 110) aged >18 years. We will compare patient-related outcomes (changes in SAB score as an indicator of difficult-to-treat infections, and CAP score as an indicator of common infections), as well as the quality and quantity of AB prescriptions. Secondary endpoints comprise quality and quantity of AB prescriptions as well as hospital-related and health economic outcomes. The statistical analysis includes a multilevel analysis. In addition, we will conduct a process evaluation, using interviews to analyse the process and the feasibility of the interventions. Results The baseline-data collection process started in April 2021. We will provide data for the broader ID and public health research communities, and publish the results in international journals to contribute to the ongoing global effort addressing AB resistance. Conclusions We highlight the purview, in terms of the multicentre, comprehensive interventions and the mixed-method approach. Key messages The study results will shed light on whether ASP+ID consultation improves AB prescription quality. We expect enhanced treatment results of ID patients in the public health sector.