{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:34:20Z","timestamp":1793072060621,"version":"4.5.0"},"reference-count":25,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/tdm\/tdmrep-policy.json"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X26105005_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Prospective audit and feedback (PAF) is a core antimicrobial stewardship strategy. Discontinuing PAF in favor of alternative interventions has not been previously evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105005_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This descriptive study assessed changes in antimicrobial days of therapy per 1,000 patient days (DOTs\/1,000 PD) following PAF removal at two urban hospitals. Preintervention PAF included daily review of broad-spectrum antibiotics and oral therapy transitions. Postintervention efforts emphasized system standardization, education, guideline optimization, and electronic medical record enhancements. Secondary outcomes included trends in antibiotics previously reviewed under PAF: antibiotics targeting methicillin-resistant\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (MRSA) or\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      , carbapenems, and oral antibiotics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105005_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Hospital A demonstrated a change in the trend of DOTs\/1,000 PD with a significant downward slope after PAF removal (\u22125.994; 95% CI \u22128.072 to \u22123.929; P &lt; .001). Hospital B continued to down-trend postintervention. At hospital A, carbapenem use decreased significantly postintervention (slope change \u22120.117; 95% CI \u22120.198 to \u22120.036; P = .007), with no changes in anti-MRSA or anti-pseudomonal agents. Hospital B demonstrated increasing use of anti-MRSA (slope change + 0.394; 95% CI 0.198 to 0.589; P &lt; .001), anti-pseudomonal (slope change + 0.378; 95% CI 0.075 to 0.681; P = .016), and carbapenem agents (slope change + 0.124; 95% CI 0.020 to 0.228; P = .021). No changes were observed in oral antibiotic use or C. difficile rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105005_as4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Shifting stewardship resources away from PAF did not increase total antibiotic use trends. Broad-spectrum antibiotics increased modestly with unclear clinical significance (\u22641.3 DOT\/1,000 PD). Antimicrobial stewardship strategies, beyond PAF, should continue to be assessed to maximize effectiveness relative to effort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10500","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:57:07Z","timestamp":1782284227000},"page":"830-835","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Exploring unconventional antimicrobial stewardship models: options beyond traditional prospective audit and feedback"],"prefix":"10.1017","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1497-3116","authenticated-orcid":false,"given":"Alyssa B.","family":"Christensen","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03s9ada67","id-type":"ROR","asserted-by":"publisher"}],"name":"HealthPartners Hospitals & Clinics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4768-2873","authenticated-orcid":false,"given":"Gary L.","family":"Cochran","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0935-6455","authenticated-orcid":false,"given":"Sean N.","family":"Avedissian","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent","family":"Footer","sequence":"additional","affiliation":[{"name":"The University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8928-4200","authenticated-orcid":false,"given":"Zachary","family":"Nelson","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03s9ada67","id-type":"ROR","asserted-by":"publisher"}],"name":"HealthPartners Hospitals & Clinics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3927-0142","authenticated-orcid":false,"given":"Maxx","family":"Enzmann","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03s9ada67","id-type":"ROR","asserted-by":"publisher"}],"name":"HealthPartners Hospitals & Clinics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Rebecca","family":"Peglow","sequence":"additional","affiliation":[{"name":"HealthPartners Hospitals & Clinics"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"S0899823X26105005_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piad112"},{"key":"S0899823X26105005_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2023.07.002"},{"key":"S0899823X26105005_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkad160"},{"key":"S0899823X26105005_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf722"},{"key":"S0899823X26105005_ref12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0271812"},{"key":"S0899823X26105005_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac787"},{"key":"S0899823X26105005_ref25","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-05501-w"},{"key":"S0899823X26105005_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/zxaf150"},{"key":"S0899823X26105005_ref17","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-024-01400-5"},{"key":"S0899823X26105005_ref24","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad453"},{"key":"S0899823X26105005_ref23","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf045"},{"key":"S0899823X26105005_ref1","unstructured":"1. Centers for Disease Control and Prevention. Core elements of hospital antibiotic stewardship programs. US Department of Health and Human Services, 2019. https:\/\/stacks.cdc.gov\/view\/cdc\/82908."},{"key":"S0899823X26105005_ref16","doi-asserted-by":"publisher","DOI":"10.1017\/ash.2024.37"},{"key":"S0899823X26105005_ref3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0150795"},{"key":"S0899823X26105005_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac289"},{"key":"S0899823X26105005_ref10","doi-asserted-by":"publisher","DOI":"10.1017\/ash.2023.186"},{"key":"S0899823X26105005_ref11","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics10111307"},{"key":"S0899823X26105005_ref13","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.294"},{"key":"S0899823X26105005_ref18","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2025.1530414"},{"key":"S0899823X26105005_ref22","unstructured":"22. Centers for disease control and prevention. COVID-19 & antimicrobial resistance. CDC website, 2025. https:\/\/www.cdc.gov\/antimicrobial-resistance\/data-research\/threats\/covid-19.html. Published February 5, 2025. Accessed May 12, 2026."},{"key":"S0899823X26105005_ref19","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis509"},{"key":"S0899823X26105005_ref20","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad025"},{"key":"S0899823X26105005_ref21","volume-title":"National Healthcare Safety Network (NHSN) Antimicrobial Use Option Report","year":"2023"},{"key":"S0899823X26105005_ref5","first-page":"1987","article-title":"ASHP national survey of pharmacy practice in hospital settings: dispensing and administration\u20142020","volume":"78","author":"Pedersen","year":"2021","journal-title":"Am J Health Syst Pharm"},{"key":"S0899823X26105005_ref2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw118"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X26105005","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X26105005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:14:40Z","timestamp":1793070880000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X26105005\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,24]]},"references-count":25,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["S0899823X26105005"],"URL":"https:\/\/doi.org\/10.1017\/ice.2026.10500","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,24]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. 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 (https:\/\/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"}]}}