{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T14:27:50Z","timestamp":1781188070560,"version":"3.54.1"},"reference-count":37,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X22002410_as1\"><jats:title>Objective:<\/jats:title><jats:p>To determine the proportion of hospitals that implemented 6 leading practices in their antimicrobial stewardship programs (ASPs). Design: Cross-sectional observational survey.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002410_as2\"><jats:title>Setting:<\/jats:title><jats:p>Acute-care hospitals.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002410_as3\"><jats:title>Participants:<\/jats:title><jats:p>ASP leaders.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002410_as4\"><jats:title>Methods:<\/jats:title><jats:p>Advance letters and electronic questionnaires were initiated February 2020. Primary outcomes were percentage of hospitals that (1) implemented facility-specific treatment guidelines (FSTG); (2) performed interactive prospective audit and feedback (PAF) either face-to-face or by telephone; (3) optimized diagnostic testing; (4) measured antibiotic utilization; (5) measured C. difficile infection (CDI); and (6) measured adherence to FSTGs.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002410_as5\"><jats:title>Results:<\/jats:title><jats:p>Of 948 hospitals invited, 288 (30.4%) completed the questionnaire. Among them, 82 (28.5%) had &lt;99 beds, 162 (56.3%) had 100\u2013399 beds, and 44 (15.2%) had \u2265400+ beds. Also, 230 (79.9%) were healthcare system members. Moreover, 161 hospitals (54.8%) reported implementing FSTGs; 214 (72.4%) performed interactive PAF; 105 (34.9%) implemented procedures to optimize diagnostic testing; 235 (79.8%) measured antibiotic utilization; 258 (88.2%) measured CDI; and 110 (37.1%) measured FSTG adherence. Small hospitals performed less interactive PAF (61.0%; P = .0018). Small and nonsystem hospitals were less likely to optimize diagnostic testing: 25.2% (P = .030) and 21.0% (P = .0077), respectively. Small hospitals were less likely to measure antibiotic utilization (67.8%; P = .0010) and CDI (80.3%; P = .0038). Nonsystem hospitals were less likely to implement FSTGs (34.3%; P &lt; .001).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22002410_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>Significant variation exists in the adoption of ASP leading practices. A minority of hospitals have taken action to optimize diagnostic testing and measure adherence to FSTGs. Additional efforts are needed to expand adoption of leading practices across all acute-care hospitals with the greatest need in smaller hospitals.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2022.241","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T11:55:57Z","timestamp":1665662157000},"page":"861-868","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":12,"title":["Use of leading practices in US hospital antimicrobial stewardship programs"],"prefix":"10.1017","volume":"44","author":[{"given":"Edward A.","family":"Stenehjem","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7098-6800","authenticated-orcid":false,"given":"Barbara I.","family":"Braun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6575-2105","authenticated-orcid":false,"given":"Salome O.","family":"Chitavi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4355-1331","authenticated-orcid":false,"given":"David Y.","family":"Hyun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2486-3268","authenticated-orcid":false,"given":"Stephen P.","family":"Schmaltz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2258-8015","authenticated-orcid":false,"given":"Mohamad G.","family":"Fakih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda M.","family":"Neuhauser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0871-334X","authenticated-orcid":false,"given":"Lisa E.","family":"Davidson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3311-4904","authenticated-orcid":false,"given":"Marc J.","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4143-6324","authenticated-orcid":false,"given":"Pranita D.","family":"Tamma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth S.","family":"Dodds-Ashley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8728-3191","authenticated-orcid":false,"given":"David W.","family":"Baker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,10,13]]},"reference":[{"key":"S0899823X22002410_ref27","first-page":"591","article-title":"Establishing an antimicrobial stewardship collaborative across a large, diverse health care system","volume":"45","author":"Logan","year":"2019","journal-title":"Jt Comm J Qual Patient Saf"},{"key":"S0899823X22002410_ref7","unstructured":"7. 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Accessed August 2, 2021."},{"key":"S0899823X22002410_ref1","doi-asserted-by":"publisher","DOI":"10.1086\/510393"},{"key":"S0899823X22002410_ref15","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1086\/511640","article-title":"Measurement of adult antibacterial drug use in 130 US hospitals: comparison of defined daily dose and days of therapy","volume":"44","author":"Polk","year":"2007","journal-title":"Clin Infect Dis"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X22002410","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T09:54:07Z","timestamp":1715162047000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X22002410\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,13]]},"references-count":37,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["S0899823X22002410"],"URL":"https:\/\/doi.org\/10.1017\/ice.2022.241","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,13]]},"assertion":[{"value":"\u00a9 The Joint Commission, 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}