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Impact of antibiotic stewardship programmes in Asia: a systematic review and meta-analysis.

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Title: Impact of antibiotic stewardship programmes in Asia: a systematic review and meta-analysis.
Authors: Lee, Chun Fan1, Cowling, Benjamin J1 bcowling@hku.hk, Feng, Shuo1, Aso, Hanae1, Wu, Peng1, Fukuda, Keiji1, Seto, Wing Hong1
Source: Journal of Deaf Studies & Deaf Education. Apr2018, Vol. 23 Issue 2, p844-851. 8p.
Subject Terms: Antibiotics, Prevention of communicable diseases, Cost control, Cross infection, Death, Drug monitoring, Drug utilization, Hand washing, Medical information storage & retrieval systems, MEDLINE, Meta-analysis, Online information services, Systematic reviews, Treatment effectiveness, Treatment duration
Geographic Terms: Asia
Abstract: Background: The use of antibiotic stewardship programmes (ASPs) is increasing in Asia, but their effectiveness in reducing antibiotic consumption and their impact on clinical outcomes is not known.Objectives: To determine the impact of ASPs conducted in Asia on the consumption of antibiotics and on patients' clinical outcomes.Methods: We systematically searched the Embase and Medline (PubMed) databases for studies that compared antibiotic consumption or clinical outcomes of patients in an Asian hospital or clinic with an ASP (intervention) with those in a similar setting without an ASP (control). Meta-analyses of all-cause mortality and hospital-acquired infection (HAI) were performed using random-effects models.Results: The search identified 77 studies of which 22 and 19 reported antibiotic usage and cost, respectively. Among these, 20 (91%) studies reported reduced antibiotic usage and 19 (100%) reported cost savings in the intervention group. Duration of antibiotic therapy was reduced in six of seven studies in association with an ASP. Rates of all-cause mortality and HAI were not significantly different between the intervention and control groups. However, mortality rates were significantly improved by ASPs using drug monitoring, while HAI rates were also improved by ASPs that included infection control or hand hygiene programmes.Conclusions: In Asia, ASPs reduce antibiotic consumption in hospital and clinic settings and do not worsen clinical outcomes. The findings strongly support the broad implementation of antimicrobial stewardship interventions in hospital and clinic settings in Asia. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Deaf Studies & Deaf Education is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Impact of antibiotic stewardship programmes in Asia: a systematic review and meta-analysis.
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  Data: <searchLink fieldCode="AR" term="%22Lee%2C+Chun+Fan%22">Lee, Chun Fan</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Cowling%2C+Benjamin+J%22">Cowling, Benjamin J</searchLink><relatesTo>1</relatesTo><i> bcowling@hku.hk</i><br /><searchLink fieldCode="AR" term="%22Feng%2C+Shuo%22">Feng, Shuo</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Aso%2C+Hanae%22">Aso, Hanae</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Wu%2C+Peng%22">Wu, Peng</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Fukuda%2C+Keiji%22">Fukuda, Keiji</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Seto%2C+Wing+Hong%22">Seto, Wing Hong</searchLink><relatesTo>1</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Deaf+Studies+%26+Deaf+Education%22">Journal of Deaf Studies & Deaf Education</searchLink>. Apr2018, Vol. 23 Issue 2, p844-851. 8p.
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  Data: <searchLink fieldCode="DE" term="%22Antibiotics%22">Antibiotics</searchLink><br /><searchLink fieldCode="DE" term="%22Prevention+of+communicable+diseases%22">Prevention of communicable diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Cost+control%22">Cost control</searchLink><br /><searchLink fieldCode="DE" term="%22Cross+infection%22">Cross infection</searchLink><br /><searchLink fieldCode="DE" term="%22Death%22">Death</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+monitoring%22">Drug monitoring</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+utilization%22">Drug utilization</searchLink><br /><searchLink fieldCode="DE" term="%22Hand+washing%22">Hand washing</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+information+storage+%26+retrieval+systems%22">Medical information storage & retrieval systems</searchLink><br /><searchLink fieldCode="DE" term="%22MEDLINE%22">MEDLINE</searchLink><br /><searchLink fieldCode="DE" term="%22Meta-analysis%22">Meta-analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Online+information+services%22">Online information services</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+duration%22">Treatment duration</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Asia%22">Asia</searchLink>
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  Label: Abstract
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  Data: <bold>Background: </bold>The use of antibiotic stewardship programmes (ASPs) is increasing in Asia, but their effectiveness in reducing antibiotic consumption and their impact on clinical outcomes is not known.<bold>Objectives: </bold>To determine the impact of ASPs conducted in Asia on the consumption of antibiotics and on patients' clinical outcomes.<bold>Methods: </bold>We systematically searched the Embase and Medline (PubMed) databases for studies that compared antibiotic consumption or clinical outcomes of patients in an Asian hospital or clinic with an ASP (intervention) with those in a similar setting without an ASP (control). Meta-analyses of all-cause mortality and hospital-acquired infection (HAI) were performed using random-effects models.<bold>Results: </bold>The search identified 77 studies of which 22 and 19 reported antibiotic usage and cost, respectively. Among these, 20 (91%) studies reported reduced antibiotic usage and 19 (100%) reported cost savings in the intervention group. Duration of antibiotic therapy was reduced in six of seven studies in association with an ASP. Rates of all-cause mortality and HAI were not significantly different between the intervention and control groups. However, mortality rates were significantly improved by ASPs using drug monitoring, while HAI rates were also improved by ASPs that included infection control or hand hygiene programmes.<bold>Conclusions: </bold>In Asia, ASPs reduce antibiotic consumption in hospital and clinic settings and do not worsen clinical outcomes. The findings strongly support the broad implementation of antimicrobial stewardship interventions in hospital and clinic settings in Asia. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Journal of Deaf Studies & Deaf Education is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1093/jac/dkx492
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 8
        StartPage: 844
    Subjects:
      – SubjectFull: Antibiotics
        Type: general
      – SubjectFull: Prevention of communicable diseases
        Type: general
      – SubjectFull: Cost control
        Type: general
      – SubjectFull: Cross infection
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      – SubjectFull: Death
        Type: general
      – SubjectFull: Drug monitoring
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      – SubjectFull: Drug utilization
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      – SubjectFull: Hand washing
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      – SubjectFull: Medical information storage & retrieval systems
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      – SubjectFull: Meta-analysis
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      – SubjectFull: Online information services
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      – SubjectFull: Systematic reviews
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      – SubjectFull: Treatment effectiveness
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      – SubjectFull: Treatment duration
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      – SubjectFull: Asia
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      – TitleFull: Impact of antibiotic stewardship programmes in Asia: a systematic review and meta-analysis.
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              Text: Apr2018
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