Scholarlink

Background and rationale <p>Current research identifies a large proportion of urinary antimicrobial prescribing in aged care as being non-concordant, however, the efficacy of interventions targeted at reducing these prescriptions in aged care remains unclear. This review summarises effective interventions targeting non-concordant urinary antimicrobial prescriptions in aged care.</p> Methods <p>This review follows PRISMA reporting guidelines and includes studies published up to June 2024. The search aimed to capture interventional studies and included studies that examined urinary tract infections in the aged care setting. All hospital-based studies and non-interventional studies were excluded. The search was conducted in 6 databases: PubMed, Scopus, Embase, PsychInfo, CINAHL Ultimate, and AgeLine. All studies were assessed against the ROBINS-I risk of bias tool. Meta-analyses for effects on urinary prescribing and hospitalisations were conducted on eligible studies and pooled risk ratios were calculated using DerSimonian and Laird random effects modelling.</p> Results <p>Twenty studies were included and interventions from four eligible randomised controlled trials were selected for the meta-analysis. The meta-analyses indicate that educational interventions coupled with routine audits were effective at reducing urinary prescribing (RR = 0.64, 95% CI = 0.49 – 0.83) and does not increase the risk of hospitalisations (RR = 1.02, 95% CI = 0.70 – 1.49). The review found that while effective interventions were heterogeneous in design, the majority included a combination of educational material(s) with routine audits and feedback for clinicians.</p> Discussion <p>Educational interventions coupled with routine audits and feedback are effective at reducing inappropriate urinary prescribing in aged care and do not increase risk of hospitalisation. The synthesis of evidence in this review is limited by the heterogeneity of these tailored interventions and the lack of consistent reporting of changes in prescribing. However, the studies pooled in the meta-analysis can give some confidence in the efficacy and safety of some of these interventions.</p> Systematic review registration <p>This review is registered with the International Prospective Register for Systematic Reviews (PROSPERO) (CRD42024569226).</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Implementation of antimicrobial stewardship interventions on prescribing rates for urinary tract infections in residential aged care facilities: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月22日

查看全文
  • Antonina Maria Lin,
  • Nadine Hillock,
  • John Turnidge,
  • Jaklin Eliott,
  • Nicola Spurrier

摘要

Background and rationale

Current research identifies a large proportion of urinary antimicrobial prescribing in aged care as being non-concordant, however, the efficacy of interventions targeted at reducing these prescriptions in aged care remains unclear. This review summarises effective interventions targeting non-concordant urinary antimicrobial prescriptions in aged care.

Methods

This review follows PRISMA reporting guidelines and includes studies published up to June 2024. The search aimed to capture interventional studies and included studies that examined urinary tract infections in the aged care setting. All hospital-based studies and non-interventional studies were excluded. The search was conducted in 6 databases: PubMed, Scopus, Embase, PsychInfo, CINAHL Ultimate, and AgeLine. All studies were assessed against the ROBINS-I risk of bias tool. Meta-analyses for effects on urinary prescribing and hospitalisations were conducted on eligible studies and pooled risk ratios were calculated using DerSimonian and Laird random effects modelling.

Results

Twenty studies were included and interventions from four eligible randomised controlled trials were selected for the meta-analysis. The meta-analyses indicate that educational interventions coupled with routine audits were effective at reducing urinary prescribing (RR = 0.64, 95% CI = 0.49 – 0.83) and does not increase the risk of hospitalisations (RR = 1.02, 95% CI = 0.70 – 1.49). The review found that while effective interventions were heterogeneous in design, the majority included a combination of educational material(s) with routine audits and feedback for clinicians.

Discussion

Educational interventions coupled with routine audits and feedback are effective at reducing inappropriate urinary prescribing in aged care and do not increase risk of hospitalisation. The synthesis of evidence in this review is limited by the heterogeneity of these tailored interventions and the lack of consistent reporting of changes in prescribing. However, the studies pooled in the meta-analysis can give some confidence in the efficacy and safety of some of these interventions.

Systematic review registration

This review is registered with the International Prospective Register for Systematic Reviews (PROSPERO) (CRD42024569226).