Consensus group on the design, analysis and reporting of antibiotic stewardship trials
Overuse of antibiotic is a major contributor to increasing resistance to antibiotics. One of the tools to reduce the inappropriate use of antibiotics is by antibiotic stewardship. Antibiotic stewardship interventions prevent antibiotic misuse by influencing the prescription behaviour of doctors. Research of antibiotic stewardship interventions are often of insufficient quality to demonstrate the safety of antibiotic stewardship. This is partly because it is unknown what are the best methods to design and analyse these interventions. We will establish a working group of experts on antibiotic stewardship and research design to determine the best way to design, analyse, and report antibiotic stewardship interventions. The goal of the working group is to formulate recommendations in a research guideline on antibiotic stewardship studies. The guideline aims to improve the quality of antibiotic stewardship research, which will lead to more effective use of recourses of safe and effective antibiotic stewardship interventions.
- Marc Bonten, University Medical Centre Utrecht, Netherlands (Coordinator)
- S.A. Walker, University College London, United Kingdom (Observer)
- M.J. Llewelyn, University of Sussex, United Kingdom (Observer)
- C.H. van Werkhoven, University Medical Centre Utrecht, Netherlands (Observer)
- V.A. Schweitzer, University Medical Centre Utrecht, Netherlands (Observer)
- Jesús Rodríguez-Baño, Hospital Universitario Virgen Macarena, Spain (Observer)
- Stephan Harbarth, University Hospitals Geneva, Switzerland (Observer)
- Evelina Tacconelli, University Hospital Tübingen, Germany (Observer)
- J.F. Timsit, INSERM, French National Institute of Health and Medical Research, France (Observer)
- M. Wolkewitz, Freiburg Center for Data Analysis and Modelling, Germany (Observer)
Antimicrobial resistance is increasing globally. One of the main instruments to counter the emergence of antimicrobial resistance is by means of antimicrobial stewardship. The goal of antimicrobial stewardship is to optimise antibiotic to reduce the selection for antimicrobial resistance by interventions that focus on changing the prescribing behaviour of physicians. In the past years, there have been many publications about possible effective stewardship interventions. However, the quality of published stewardship studies is low. As a consequence, the evidence base for stewardship interventions is weak and does not guide clinical practise. As part of the working group we conducted a comprehensive systematic review of the stewardship literature to identify where the quality of stewardship studies is most lacking. In addition, we organised two consensus meetings with experts on both antimicrobial steward and study design to discuss which recommendations are needed to improve the quality of studies. Based on the systematic review and consensus meetings we formulated recommendations that will be published in a white paper with the goal to inform researchers about how to properly conduct studies on antimicrobial stewardship interventions.