{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:36:39Z","timestamp":1792143399197,"version":"4.4.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antimicrobial stewardship programs (ASPs) are essential to improve antibiotic prescribing. This study evaluated the impact of a post-prescription audit and feedback intervention on carbapenem prescribing appropriateness in a large university hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study utilized interrupted time series (ITS) analysis, employing an Autoregressive Integrated Moving Average (ARIMA) model, to assess carbapenem prescribing across three consecutive phases: a 12-month pre-intervention, a 6-month intervention, and a 6-month post-intervention follow-up. Carbapenem prescribing appropriateness was retrospectively evaluated using an in-house developed algorithm, based on international and national guidelines and institutional protocols. The intervention involved bedside consultations by infectious diseases specialists employing a post-prescription audit with face-to-face feedback.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We evaluated 1825 carbapenem therapies, primarily prescribed for suspected\/confirmed bloodstream infections (46%, 843\/1825). Among these, 458 (25%) were deemed inappropriate, mainly due to unnecessarily broad-spectrum use (72%, 331\/458). The ITS-ARIMA model showed an immediate 11% reduction in the rate of inappropriate prescriptions during the first month of intervention phase (P\u200a=\u200a0.001), followed by a non-significant downward trend during the remaining intervention period. However, an immediate 14.9% increase in inappropriate prescriptions was observed at the onset of the post-intervention phase (P\u200a=\u200a0.001), indicating a rebound effect after the withdrawal of the active stewardship intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implementing a post-prescription audit and face-to-face feedback intervention was associated with a short-term improvement in carbapenem prescribing appropriateness. We observed a reduction in the trend of inappropriateness, although this change was not statistically significant. Future studies should investigate strategies for implementing sustainable ASPs optimizing human resources and time investment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jacamr\/dlaf236","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T12:50:27Z","timestamp":1764075027000},"source":"Crossref","is-referenced-by-count":5,"title":["Impact of a post-prescription audit and feedback antimicrobial stewardship intervention on inappropriate carbapenem prescribing: an interrupted time series analysis"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7267-8068","authenticated-orcid":false,"given":"Flavio","family":"Sangiorgi","sequence":"first","affiliation":[{"name":"Dipartimento di Sicurezza e Bioetica, Universit\u00e0 Cattolica del Sacro Cuore , Rome ,","place":["Italy"]},{"name":"UOC Malattie Infettive ad Interesse Chirurgico, Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Del Vecchio","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive\u2014Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. 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