{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T03:45:29Z","timestamp":1791776729015,"version":"4.3.4"},"reference-count":20,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X26104437_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>To support Antimicrobial Stewardship programs (ASPs) as well as the clinical care of patients with infections, we disseminated and implemented a Videoconference Antimicrobial Stewardship Team (VAST) to connect multidisciplinary teams from rural Veterans Affairs (VA) medical centers with geographically distant ID experts. Here, we describe the clinical syndromes discussed and the response to recommendations made during VAST sessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104437_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between September 2021 to February 2024, eight ID consultants established VASTs with ten rural VAMCs, holding regularly scheduled videoconference sessions to discuss clinical cases and provide recommendations. Data were collected on patient demographics, clinical syndromes, and recommendations. Acceptance of recommendations within one week of each session was assessed via chart review. Six months after the intervention began, we conducted semi-structured interviews to assess participants\u2019 perceptions of VASTs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104437_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>VASTs reviewed 626 cases involving 527 unique patients. Among 763 clinical syndromes discussed, the most common were infections of the respiratory (29%) or urinary tract (21%). Overall, VASTs made 973 recommendations, of which 71% were accepted. Of 570 recommendations related to antibiotics, 459 (80%) were accepted. Among 403 other recommendations, 235 (58%) were accepted. Interviews with participants indicated the importance of building trust and strong interpersonal relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104437_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>VASTs effectively supported Antimicrobial Stewardship in rural VA medical centers (VAMCs) without local ID expertise. High acceptance rates, particularly for antibiotic-related recommendations, suggest that telehealth-enabled provider-to-provider models enhance stewardship efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10443","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T05:21:10Z","timestamp":1777872070000},"page":"710-717","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Recommendations made and accepted by a telehealth-enabled Antimicrobial Stewardship program implemented at rural veterans affairs medical centers"],"prefix":"10.1017","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4797-1432","authenticated-orcid":false,"given":"Taissa A.","family":"Bej","sequence":"first","affiliation":[{"name":"Geriatric Research Education and Clinical Center (GRECC), VA Northeast Ohio Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia L.","family":"Milner","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center (GRECC), VA Northeast Ohio Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandria","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center (GRECC), VA Northeast Ohio Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8950-527X","authenticated-orcid":false,"given":"Amanda","family":"Vivo","sequence":"additional","affiliation":[{"name":"VA Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3850-7689","authenticated-orcid":false,"given":"Geneva","family":"Wilson","sequence":"additional","affiliation":[{"name":"VA Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital"},{"name":"Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1597-7570","authenticated-orcid":false,"given":"Sara","family":"Abdelrahim","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center (GRECC), VA Northeast Ohio Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2966-2940","authenticated-orcid":false,"given":"Brigid M.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center (GRECC), VA Northeast Ohio Healthcare System"},{"name":"Department of Medicine, Case Western Reserve University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0846-7141","authenticated-orcid":false,"given":"Corinne","family":"Kowal","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center (GRECC), VA Northeast Ohio Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3139-0035","authenticated-orcid":false,"given":"Sunah","family":"Song","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center (GRECC), VA Northeast Ohio Healthcare System"},{"name":"Cleveland Institute for Computational Biology, Case Western Reserve University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1477-3659","authenticated-orcid":false,"given":"Keri L.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"The Center for Healthcare Evaluation, Research, and Promotion (CHERP), VA Pittsburgh Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7299-4214","authenticated-orcid":false,"given":"Nicole","family":"Beyer","sequence":"additional","affiliation":[{"name":"The Center for Healthcare Evaluation, Research, and Promotion (CHERP), VA Pittsburgh Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Michaels","sequence":"additional","affiliation":[{"name":"The Center for Healthcare Evaluation, Research, and Promotion (CHERP), VA Pittsburgh Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7105-5274","authenticated-orcid":false,"given":"Carla","family":"Amundson","sequence":"additional","affiliation":[{"name":"Minneapolis Veterans Affairs Health Care System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3229-5590","authenticated-orcid":false,"given":"Kristina L.","family":"Bajema","sequence":"additional","affiliation":[{"name":"VA Portland Health Care System"},{"name":"Department of Medicine, Oregon Health & Science University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4777-3006","authenticated-orcid":false,"given":"Jason P.","family":"Burnham","sequence":"additional","affiliation":[{"name":"St. Louis Veterans Affairs Medical Center"},{"name":"Washington University in St. Louis School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9320-9262","authenticated-orcid":false,"given":"Christopher J.","family":"Crnich","sequence":"additional","affiliation":[{"name":"William S. Middleton Memorial VA Hospital"},{"name":"University of Wisconsin School of Medicine and Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6993-4704","authenticated-orcid":false,"given":"Dimitri M.","family":"Drekonja","sequence":"additional","affiliation":[{"name":"Minneapolis Veterans Affairs Health Care System"},{"name":"University of Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1175-1112","authenticated-orcid":false,"given":"Lauren","family":"Epstein","sequence":"additional","affiliation":[{"name":"Atlanta VA Medical Center"},{"name":"Emory University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3078-7428","authenticated-orcid":false,"given":"Tola","family":"Ewers","sequence":"additional","affiliation":[{"name":"William S. Middleton Memorial VA Hospital"},{"name":"University of Wisconsin School of Medicine and Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8523-214X","authenticated-orcid":false,"given":"Daniel J.","family":"Livorsi","sequence":"additional","affiliation":[{"name":"Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System"},{"name":"University of Iowa Carver College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muthu","family":"Narayan","sequence":"additional","affiliation":[{"name":"Minneapolis Veterans Affairs Health Care System"},{"name":"University of Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9644-501X","authenticated-orcid":false,"given":"Joshua D.","family":"Nordman","sequence":"additional","affiliation":[{"name":"St. Louis Veterans Affairs Medical Center"},{"name":"Washington University in St. Louis School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2642-3266","authenticated-orcid":false,"given":"Federico","family":"Perez","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center (GRECC), VA Northeast Ohio Healthcare System"},{"name":"Department of Medicine, Case Western Reserve University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1893-5771","authenticated-orcid":false,"given":"Christopher D.","family":"Pfeiffer","sequence":"additional","affiliation":[{"name":"VA Portland Health Care System"},{"name":"Department of Medicine, Oregon Health & Science University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4328-8676","authenticated-orcid":false,"given":"Rabeeya","family":"Sabzwari","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Edward Hines Jr. VA Hospital"},{"name":"Loyola University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8924-6119","authenticated-orcid":false,"given":"Ahmed M.","family":"Salti","sequence":"additional","affiliation":[{"name":"VA Portland Health Care System"},{"name":"College of Osteopathic Medicine of the Pacific \u2013 Northwest"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Tate","sequence":"additional","affiliation":[{"name":"St. Louis Veterans Affairs Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1632-2464","authenticated-orcid":false,"given":"Tammy","family":"Walkner","sequence":"additional","affiliation":[{"name":"Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew S.","family":"Webster","sequence":"additional","affiliation":[{"name":"Atlanta VA Medical Center"},{"name":"Emory University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0696-8288","authenticated-orcid":false,"given":"Charlesnika T.","family":"Evans","sequence":"additional","affiliation":[{"name":"VA Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital"},{"name":"Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5601-8996","authenticated-orcid":false,"given":"Robin L.P.","family":"Jump","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Pittsburgh School of Medicine"},{"name":"Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs (VA) Pittsburgh Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"S0899823X26104437_ref5","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac588"},{"key":"S0899823X26104437_ref17","first-page":"296","article-title":"Implementing a tele-expertise system to optimise the antibiotic use and stewardship: the case of the Montpellier University Hospital (France)","volume":"210","author":"Morquin","year":"2015","journal-title":"Stud Health Technol Inform"},{"key":"S0899823X26104437_ref9","doi-asserted-by":"publisher","DOI":"10.1086\/497143"},{"key":"S0899823X26104437_ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s40506-021-00256-7"},{"key":"S0899823X26104437_ref1","unstructured":"1. CDC. Antimicrobial resistance facts and stats. Antimicrobial resistance. 2025. https:\/\/www.cdc.gov\/antimicrobial-resistance\/data-research\/facts-stats\/index.html. Accessed March 11, 2025."},{"key":"S0899823X26104437_ref8","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2018.197"},{"key":"S0899823X26104437_ref16","first-page":"100131","article-title":"Coaching ward pharmacists in Antimicrobial Stewardship: a pilot study","volume":"5","author":"Khumra","year":"2022","journal-title":"Explor Res Clin Soc Pharm"},{"key":"S0899823X26104437_ref2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw118"},{"key":"S0899823X26104437_ref11","doi-asserted-by":"publisher","DOI":"10.1086\/650482"},{"key":"S0899823X26104437_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2023.07.005"},{"key":"S0899823X26104437_ref4","unstructured":"4. Infectious Diseases Pharmacy - Board of Pharmacy Specialties. https:\/\/bpsweb.org\/infectious-diseases-pharmacy\/. Accessed December 14, 2025."},{"key":"S0899823X26104437_ref13","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy1121"},{"key":"S0899823X26104437_ref14","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq257"},{"key":"S0899823X26104437_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad620"},{"key":"S0899823X26104437_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf485"},{"key":"S0899823X26104437_ref18","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac458"},{"key":"S0899823X26104437_ref10","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw353"},{"key":"S0899823X26104437_ref12","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1581ST"},{"key":"S0899823X26104437_ref3","doi-asserted-by":"publisher","DOI":"10.7326\/M20-2684"},{"key":"S0899823X26104437_ref19","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2023.81"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X26104437","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T03:05:06Z","timestamp":1791774306000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X26104437\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":20,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["S0899823X26104437"],"URL":"https:\/\/doi.org\/10.1017\/ice.2026.10443","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]},"assertion":[{"value":"\u00a9 Department of Veterans Affairs, 2026","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is a work of the US Government and is not subject to copyright protection within the United States. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}