Journal article
Opportunities and challenges in improving antimicrobial use during the era of telehealth expansion: A narrative review
Antimicrobial Stewardship & Healthcare Epidemiology : ASHE, Vol.1(1), pp.e26-e26
10/06/2021
DOI: 10.1017/ash.2021.191
PMCID: PMC9495641
PMID: 36168461
Abstract
Efforts to improve antimicrobial prescribing are occurring within a changing healthcare landscape, which includes the expanded use of telehealth technology. The wider adoption of telehealth presents both challenges and opportunities for promoting antimicrobial stewardship. Telehealth provides 2 avenues for remote infectious disease (ID) specialists to improve inpatient antimicrobial prescribing: telehealth-supported antimicrobial stewardship and tele-ID consultations. Those 2 activities can work separately or synergistically. Studies on telehealth-supported antimicrobial stewardship have reported a reduction in inpatient antimicrobial prescribing, cost savings related to less antimicrobial use, a decrease in
Clostridioides difficile
infections, and improved antimicrobial susceptibility patterns for common organisms. Tele-ID consultation is associated with fewer hospital transfers, a shorter length of hospital stay, and decreased mortality. The implementation of these activities can be flexible depending on local needs and available resources, but several barriers may be encountered. Opportunities also exist to improve antimicrobial use in outpatient settings. Telehealth provides a more rapid mechanism for conducting outpatient ID consultations, and increasing use of telehealth for routine and urgent outpatient visits present new challenges for antimicrobial stewardship. In primary care, urgent care, and emergency care settings, unnecessary antimicrobial use for viral acute respiratory tract infections is common during telehealth encounters, as is the case for fact-to-face encounters. For some diagnoses, such as otitis media and pharyngitis, antimicrobials are further overprescribed via telehealth. Evidence is still lacking on the optimal stewardship strategies to improve antimicrobial prescribing during telehealth encounters in ambulatory care, but conventional outpatient stewardship strategies are likely transferable. Further work is warranted to fill this knowledge gap.
Details
- Title: Subtitle
- Opportunities and challenges in improving antimicrobial use during the era of telehealth expansion: A narrative review
- Creators
- Hiroyuki Suzuki - , Iowa City Veterans’ Affairs Health Care System, , Department of Internal Medicine, , , , , Department of Pharmacy, , , Division of Infectious Diseases and Clinical EpidemiologyStephanie C. Shealy - , Iowa City Veterans’ Affairs Health Care System, , Department of Internal Medicine, , , , , Department of Pharmacy, , , Division of Infectious Diseases and Clinical EpidemiologyKyle Throneberry - , Iowa City Veterans’ Affairs Health Care System, , Department of Internal Medicine, , , , , Department of Pharmacy, , , Division of Infectious Diseases and Clinical EpidemiologyEdward Stenehjem - , Iowa City Veterans’ Affairs Health Care System, , Department of Internal Medicine, , , , , Department of Pharmacy, , , Division of Infectious Diseases and Clinical EpidemiologyDaniel Livorsi - , Iowa City Veterans’ Affairs Health Care System, , Department of Internal Medicine, , , , , Department of Pharmacy, , , Division of Infectious Diseases and Clinical Epidemiology
- Resource Type
- Journal article
- Publication Details
- Antimicrobial Stewardship & Healthcare Epidemiology : ASHE, Vol.1(1), pp.e26-e26
- DOI
- 10.1017/ash.2021.191
- PMID
- 36168461
- PMCID
- PMC9495641
- NLM abbreviation
- Antimicrob Steward Healthc Epidemiol
- ISSN
- 2732-494X
- eISSN
- 2732-494X
- Publisher
- Cambridge University Press
- Language
- English
- Date published
- 10/06/2021
- Academic Unit
- Infectious Diseases; Internal Medicine
- Record Identifier
- 9984359946402771
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