An Online Platform for Expanding Antibiotic Stewardship (OPEN Stewardship)



Antibiotic resistance is a mounting public health threat calling for action on global, national and local levels. Antibiotic use has been a major driver of increasing rates of antibiotic resistance. This has given rise to the practice of antibiotic stewardship, which seeks to reduce unnecessary antibiotic use across different care settings.

Ongoing project

Antibiotic stewardship has been increasingly applied in hospital settings, but adoption has been slow in many ambulatory care settings including primary care of humans. Uptake of antibiotic stewardship in veterinary care has been similarly limited. Audit and feedback systems of antibiotic use coupled with patterns of antibiotic use and best practice guidelines have proven useful in outpatient settings, but scale-up is limited by heterogeneous systems of care and limited resources.

We aim to develop an open web-based system that allows for advanced stewardship interventions in the form of feedback and benchmarking as well as sharing of best practice guidelines and antibiotic resistance patterns. The proposed model can be rapidly expanded across health systems, countries, and sectors (animal vs. human), with minimal resource expenditures. We will build upon an existing platform for monitoring antibiotic resistance, and pilot these interventions with international providers in both medicine and veterinary medicine, in the form of an interrupted time series analysis. Outcomes will focus on platform development, interface usability, and prescription patterns during the study.

Project partners

  • David Fisman, University of Toronto, Canada (Coordinator)
  • Sonja Löfmark, Public Health Agency of Sweden, Sweden
  • Amy Greer, University of Guelph, Canada
  • Nadav Davidovitch, Ben-Gurion University, Israel
  • Moriah Ellen, Jerusalem College of Technology, Israel
  • John Brownstein, Harvard Medical School, USA
  • Derek MacFadden, Boston Children’s Hospital, USA