{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:17:03Z","timestamp":1787008623276,"version":"build-2736575974"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T00:00:00Z","timestamp":1666310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004837","name":"Spanish Ministry of Science and Innovation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"crossref"}]},{"name":"European Development Regional Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antimicrobial stewardship programs (ASPs) are recommended in nursing homes (NHs), although data are limited. We aimed to determine the clinical and ecological impact of an ASP for NHs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a cluster, randomized, controlled trial and a before\u2013after study with interrupted time-series analyses in 14 NHs for 30 consecutive months from July 2018 to December 2020 in Andalusia, Spain. Seven facilities implemented an ASP with a bundle of 5 educational measures (general ASP) and 7 added 1-to-1 educational interviews (experimental ASP). The primary outcome was the overall use of antimicrobials, calculated monthly as defined daily doses (DDD) per 1000 resident days (DRD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The total mean antimicrobial consumption decreased by 31.2% (\u221216.72 DRD; P = .045) with respect to the preintervention period; the overall use of quinolones and amoxicillin\u2013clavulanic acid dropped by 52.2% (P = .001) and 42.5% (P = .006), respectively; and the overall prevalence of multidrug-resistant organisms (MDROs) decreased from 24.7% to 17.4% (P = .012). During the intervention period, 12.5 educational interviews per doctor were performed in the experimental ASP group; no differences were found in the total mean antimicrobial use between groups (\u221214.62 DRD; P = .25). Two unexpected coronavirus disease 2019 waves affected the centers increasing the overall mean use of antimicrobials by 40% (51.56 DRD; P &amp;lt; .0001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study suggests that an ASP for NHs appears to be associated with a decrease in total consumption of antimicrobials and prevalence of MDROs. This trial did not find benefits associated with educational interviews, probably due to the coronavirus disease 2019 pandemic.<\/jats:p>\n                    <jats:p>Clinical Trials Registration. NCT03543605.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciac834","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T12:04:28Z","timestamp":1666267468000},"page":"824-832","source":"Crossref","is-referenced-by-count":11,"title":["Clinical and Ecological Impact of an Educational Program to Optimize Antibiotic Treatments in Nursing Homes (PROA-SENIOR): A Cluster, Randomized, Controlled Trial and Interrupted Time-Series Analysis"],"prefix":"10.1093","volume":"76","author":[{"given":"Germ\u00e1n","family":"Pe\u00f1alva","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Microbiology and Parasitology, Institute of Biomedicine of Seville, University Hospital Virgen del Roc\u00edo, Spanish National Research Council, University of Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Crespo-Rivas","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Microbiology and Parasitology, Institute of Biomedicine of Seville, University Hospital Virgen del Roc\u00edo, Spanish National Research Council, University of Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Bel\u00e9n","family":"Guisado-Gil","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Microbiology and Parasitology, Institute of Biomedicine of Seville, University Hospital Virgen del Roc\u00edo, Spanish National Research Council, University of Seville , Spain"},{"name":"Department of Pharmacy, University Hospital Virgen del Roc\u00edo , Seville , Spain"},{"name":"CIBERINFECT, Center for Biomedical Research Network on Infectious Diseases , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngel","family":"Rodr\u00edguez-Villodres","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Microbiology and Parasitology, Institute of Biomedicine of Seville, University Hospital Virgen del Roc\u00edo, Spanish National Research Council, University of Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Eugenia","family":"Pach\u00f3n-Ib\u00e1\u00f1ez","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Microbiology and Parasitology, Institute of Biomedicine of Seville, University Hospital Virgen del Roc\u00edo, Spanish National Research Council, University of Seville , Spain"},{"name":"CIBERINFECT, Center for Biomedical Research Network on Infectious Diseases , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1rbara","family":"Cachero-Alba","sequence":"additional","affiliation":[{"name":"Nursing Home of Jerez de la Frontera , C\u00e1diz , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blas","family":"Rivas-Romero","sequence":"additional","affiliation":[{"name":"Nursing Home of Linares , 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