Addressing antibiotic resistance through interdisciplinary collaboration between nursing and pharmacy
Keywords:
antimicrobial stewardship, nursing, pharmacy, interdisciplinary teamwork, antibiotic resistance, healthcare tacticsAbstract
Background: By compromising the effectiveness of life-saving therapies and driving up healthcare expenses, antibiotic resistance (AR) is a serious danger to global public health. Effective mitigation solutions are desperately needed, as the World Health Organization (WHO) has declared AR a high global health concern. As frontline healthcare professionals, nurses and pharmacists have distinct and complementary roles in antimicrobial stewardship (AMS). Their capacity to have a collaborative impact is still untapped, though. Aim: this research is to analyze the multidisciplinary cooperation between pharmacy and nursing in tackling AR, emphasizing how well it works to improve patient outcomes, lower resistance rates, and strengthen AMS programs. The research highlights obstacles, investigates facilitators, and offers practical suggestions for incorporating these functions into a unified approach to counter AR. Methods: To better understand interdisciplinary approaches to AR management, a thematic assessment of peer-reviewed literature, clinical guidelines, and case studies was carried out. To find trends of cooperation, common difficulties, and proof of achievement, data were combined. Results: By optimizing antibiotic use, enhancing patient education, and guaranteeing adherence to infection control guidelines, interdisciplinary collaboration between nursing and pharmacy improves AMS.
Downloads
References
One Health High-Level Expert Panel. (2021). One Health definition. World Health Organization.
Centers for Disease Control and Prevention (CDC). (2021). Antibiotic resistance threats in the United States. CDC Press.
Dyar, O. J., Huttner, B., Schouten, J., & Pulcini, C. (2017). What is antimicrobial stewardship? Clinical Microbiology and Infection, 23(11), 793–798.
Tamma, P. D., Aitken, S. L., Bonomo, R. A., & Mathers, A. J. (2021). Multidrug-resistant gram-negative bacteria: Epidemiology and management. Clinical Infectious Diseases, 72(11), 1995–2004.
Fleming-Dutra, K. E., Hersh, A. L., & Shapiro, D. J. (2016). Prevalence of inappropriate antibiotic prescriptions. JAMA, 315(17), 1864–1873.
Tacconelli, E., Carrara, E., Savoldi, A., Harbarth, S., Mendelson, M., Monnet, D. L., et al. (2018). Discovery, research, and development of new antibiotics: The WHO priority list. The Lancet Infectious Diseases, 18(3), 318–327.
Nicolle, L. E., Gupta, K., & Bradley, S. F. (2020). Antimicrobial stewardship in long-term care facilities. Clinical Infectious Diseases, 70(11), 1973–1981.
Rawson, T. M., Moore, L. S. P., Castro-Sánchez, E., Charani, E., Davies, F., & Holmes, A. H. (2020). COVID-19 and antimicrobial resistance. Journal of Antimicrobial Chemotherapy, 75(7), 1681–1690.
O’Neill, J. (2016). Tackling drug-resistant infections globally: Final report and recommendations. Review on Antimicrobial Resistance.
World Health Organization (WHO). (2019). No time to wait: Securing the future from drug-resistant infections. WHO Press.
Centers for Disease Control and Prevention (CDC). (2019). Antibiotic resistance threats in the United States, 2019. CDC Press.
Laxminarayan, R., Van Boeckel, T., & Teillant, A. (2015). The economic costs of antibiotic resistance: A review of the literature. Health Economics, 24(10), 1243–1250.
World Health Organization (WHO). (2017). Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics. WHO Press.
Chokshi, A., Sifri, Z., & Patel, R. (2019). Global contributors to antibiotic resistance. Journal of Global Infectious Diseases, 11(1), 36–42. DOI: https://doi.org/10.4103/jgid.jgid_110_18
World Health Organization (WHO). (2020). Global antimicrobial resistance surveillance system (GLASS) report 2020. WHO Press.
Munita, J. M., & Arias, C. A. (2016). Mechanisms of antibiotic resistance. Microbiology Spectrum, 4(2). DOI: https://doi.org/10.1128/microbiolspec.VMBF-0016-2015
Partridge, S. R., Kwong, S. M., Firth, N., & Jensen, S. O. (2018). Mobile genetic elements associated with antimicrobial resistance. Clinical Microbiology Reviews, 31(4), e00088-17. DOI: https://doi.org/10.1128/CMR.00088-17
Tacconelli, E., & Pezzani, M. D. (2019). Public health burden of antimicrobial resistance in Europe. The Lancet Infectious Diseases, 19(1), 4–6.
Nordmann, P., Naas, T., & Poirel, L. (2011). Global spread of carbapenemase-producing Enterobacteriaceae. Emerging Infectious Diseases, 17(10), 1791–1798. DOI: https://doi.org/10.3201/eid1710.110655
Berendonk, T. U., Manaia, C. M., Merlin, C., Fatta-Kassinos, D., Cytryn, E., Walsh, F., & Michael, I. (2015). Tackling antibiotic resistance: The environmental framework. Nature Reviews Microbiology, 13(5), 310–317. DOI: https://doi.org/10.1038/nrmicro3439
Fleming-Dutra, K. E., Hersh, A. L., & Shapiro, D. J. (2016). Prevalence of inappropriate antibiotic prescriptions. JAMA, 315(17), 1864–1873. DOI: https://doi.org/10.1001/jama.2016.4151
Klein, E. Y., Van Boeckel, T. P., Martinez, E. M., Pant, S., Gandra, S., Levin, S. A., & Laxminarayan, R. (2018). Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. PNAS, 115(15), E3463–E3470.
WHO. (2021). Global Antimicrobial Resistance Surveillance System (GLASS): 2020 Report. WHO Press.
Cassini, A., Högberg, L. D., Plachouras, D., Quattrocchi, A., Hoxha, A., Simonsen, G. S., & Kretzschmar, M. E. (2019). Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and European Economic Area. The Lancet Infectious Diseases, 19(1), 56–66. DOI: https://doi.org/10.1016/S1473-3099(18)30708-4
Renwick, M. J., Brogan, D. M., & Mossialos, E. (2016). A systematic review and critical assessment of incentive strategies for discovery and development of novel antibiotics. Journal of Antibiotics, 69(2), 73–88. DOI: https://doi.org/10.1038/ja.2015.98
Pittet, D., & Boyce, J. M. (2001). Hand hygiene and patient care: Pursuing the Semmelweis legacy. The Lancet Infectious Diseases, 1(1), 9–20.
Centers for Disease Control and Prevention (CDC). (2019). Antibiotic resistance threats in the United States, 2019. CDC Press.
Klein, E. Y., Van Boeckel, T. P., Martinez, E. M., Pant, S., Gandra, S., Levin, S. A., & Laxminarayan, R. (2018). Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. PNAS, 115(15), E3463–E3470.
Dyar, O. J., Obua, C., Chandy, S., Xiao, Y., Stålsby Lundborg, C., & Pulcini, C. (2016). Using antibiotics responsibly: Are we there yet? BMJ Global Health, 1(3), e000091.
Magill, S. S., O’Leary, E., Janelle, S. J., Thompson, D. L., Dumyati, G., Nadle, J., et al. (2018). Changes in prevalence of healthcare-associated infections in U.S. hospitals. New England Journal of Medicine, 379(18), 1732–1744. DOI: https://doi.org/10.1056/NEJMoa1801550
Pittet, D., & Boyce, J. M. (2001). Hand hygiene and patient care: Pursuing the Semmelweis legacy. The Lancet Infectious Diseases, 1(1), 9–20.
Gould, D. J., Moralejo, D., Drey, N., & Chudleigh, J. H. (2017). Interventions to improve hand hygiene compliance in patient care. Cochrane Database of Systematic Reviews, 9(2), CD005186. DOI: https://doi.org/10.1002/14651858.CD005186.pub4
Tacconelli, E., & Pezzani, M. D. (2019). Public health burden of antimicrobial resistance in Europe. The Lancet Infectious Diseases, 19(1), 4–6. DOI: https://doi.org/10.1016/S1473-3099(18)30648-0
Tamma, P. D., Miller, M. A., & Cosgrove, S. E. (2019). Rethinking how antibiotics are prescribed: Incorporating the 4 moments of antibiotic decision making. JAMA, 321(2), 139–140. DOI: https://doi.org/10.1001/jama.2018.19509
Aiken, L. H., Sloane, D. M., Ball, J., Bruyneel, L., Rafferty, A. M., & Griffiths, P. (2018). Patient satisfaction with hospital care and nurses in England: An observational study. BMJ Open, 8(1), e019189. DOI: https://doi.org/10.1136/bmjopen-2017-019189
Rawson, T. M., Moore, L. S. P., Castro-Sánchez, E., Charani, E., Davies, F., & Holmes, A. H. (2020). COVID-19 and antimicrobial resistance. Journal of Antimicrobial Chemotherapy, 75(7), 1681–1690.
Kollef, M. H., Morrow, L. E., Niederman, M. S., Shorr, A. F., Leeper, K. V., & Anzueto, A. (2018). Clinical characteristics and treatment patterns among patients with ventilated hospital-acquired and ventilator-associated bacterial pneumonia. Chest, 154(5), 999–1007.
McDonnell, A., & Wood, R. (2019). Adverse drug reactions associated with antibiotic use. Therapeutic Advances in Drug Safety, 10, 1–16.
Monaghesh, E., & Hajizadeh, A. (2020). The role of telehealth during COVID-19 outbreak: A systematic review. BMC Public Health, 20(1), 1–9.
Barlam, T. F., Cosgrove, S. E., Abbo, L. M., MacDougall, C., Schuetz, A. N., Septimus, E. J., & Weber, D. J. (2016). Implementing an antibiotic stewardship program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clinical Infectious Diseases, 62(10), e51–e77.
Dellit, T. H., Owens, R. C., McGowan, J. E., Gerding, D. N., Weinstein, R. A., Burke, J. P., & Hooton, T. M. (2007). Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clinical Infectious Diseases, 44(2), 159–177.
Goff, D. A., Kullar, R., Bauer, K. A., File, T. M., Zervos, M. J., & Hermsen, E. D. (2017). Eight habits of highly effective antimicrobial stewardship programs to meet the joint commission standards for hospitals. Clinical Infectious Diseases, 64(8), 1134–1139.
Drusano, G. L. (2004). Antimicrobial pharmacodynamics: Critical interactions of ‘bug and drug.’ Nature Reviews Microbiology, 2(4), 289–300. DOI: https://doi.org/10.1038/nrmicro862
Tacconelli, E., Carrara, E., Savoldi, A., Harbarth, S., Mendelson, M., Monnet, D. L., & Rice, L. B. (2018). Discovery, research, and development of new antibiotics: The WHO priority list of antibiotic-resistant bacteria and tuberculosis. The Lancet Infectious Diseases, 18(3), 318–327.
Centers for Disease Control and Prevention (CDC). (2019). Antibiotic resistance threats in the United States, 2019. CDC Press.
Lee, T. C., Zvonar, R. K., & Nickerson, A. (2014). Antibiotic stewardship: Future directions. Canadian Journal of Hospital Pharmacy, 67(5), 388–394.
Garau, J., Bassetti, M., & Peghin, M. (2018). Hospital antimicrobial stewardship (AMS) programs in critically ill patients. Current Opinion in Infectious Diseases, 31(4), 420–427.
Dyar, O. J., Huttner, B., Schouten, J., & Pulcini, C. (2017). What is antimicrobial stewardship? Clinical Microbiology and Infection, 23(11), 793–798. DOI: https://doi.org/10.1016/j.cmi.2017.08.026
Abbo, L. M., & Hooton, T. M. (2014). Antimicrobial stewardship and urinary tract infections. Antimicrobial Resistance & Infection Control, 3(1), 1–13. DOI: https://doi.org/10.1186/2047-2994-3-23
Monaghesh, E., & Hajizadeh, A. (2020). The role of telehealth during COVID-19 outbreak: A systematic review. BMC Public Health, 20(1), 1–9.
Howard, P., Pulcini, C., Hara, G. L., West, R. M., Gould, I. M., Harbarth, S., & Nathwani, D. (2015). An international cross-sectional survey of antimicrobial stewardship programmes in hospitals. Journal of Antimicrobial Chemotherapy, 70(4), 1245–1255. DOI: https://doi.org/10.1093/jac/dku497
Clarke, G. M., Dias, R., & Friedman, A. (2020). Implementing stewardship in hospitals: Challenges and successes. Pharmacy Practice, 18(1), 10–20.
Vestal, G. (2017). Hospital antibiotic stewardship programs. Antibiotics, 6(4), 36.
Laxminarayan, R., Matsoso, P., Pant, S., Brower, C., Røttingen, J. A., Klugman, K., & Davies, S. (2016). Access to effective antimicrobials: A worldwide challenge. The Lancet, 387(10014), 168–175.
Schuts, E. C., Hulscher, M. E. J. L., Mouton, J. W., Verduin, C. M., Stuart, J. W., Overdiek, H. W. P. M., & Natsch, S. (2016). Current evidence on hospital antimicrobial stewardship objectives: A systematic review and meta-analysis. The Lancet Infectious Diseases, 16(7), 847–856.
Barlam, T. F., Cosgrove, S. E., Abbo, L. M., MacDougall, C., Schuetz, A. N., Septimus, E. J., & Weber, D. J. (2016). Implementing an antibiotic stewardship program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clinical Infectious Diseases, 62(10), e51–e77.
Lee, T. C., Zvonar, R. K., & Nickerson, A. (2014). Antibiotic stewardship: Future directions. Canadian Journal of Hospital Pharmacy, 67(5), 388–394.
Goff, D. A., Kullar, R., Bauer, K. A., File, T. M., Zervos, M. J., & Hermsen, E. D. (2017). Eight habits of highly effective antimicrobial stewardship programs to meet the joint commission standards for hospitals. Clinical Infectious Diseases, 64(8), 1134–1139.
Tacconelli, E., Carrara, E., Savoldi, A., Harbarth, S., Mendelson, M., Monnet, D. L., & Rice, L. B. (2018). Discovery, research, and development of new antibiotics: The WHO priority list of antibiotic-resistant bacteria and tuberculosis. The Lancet Infectious Diseases, 18(3), 318–327.
Dellit, T. H., Owens, R. C., McGowan, J. E., Gerding, D. N., Weinstein, R. A., Burke, J. P., & Hooton, T. M. (2007). Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clinical Infectious Diseases, 44(2), 159–177.
Rawson, T. M., Moore, L. S. P., Castro-Sánchez, E., Charani, E., Davies, F., & Holmes, A. H. (2020). COVID-19 and antimicrobial resistance. Journal of Antimicrobial Chemotherapy, 75(7), 1681–1690.
Laxminarayan, R., Matsoso, P., Pant, S., Brower, C., Røttingen, J. A., Klugman, K., & Davies, S. (2016). Access to effective antimicrobials: A worldwide challenge. The Lancet, 387(10014), 168–175.
Nicolle, L. E., Gupta, K., & Bradley, S. F. (2020). Antimicrobial stewardship in long-term care facilities. Clinical Infectious Diseases, 70(11), 1973–1981.
Pittet, D., & Boyce, J. M. (2001). Hand hygiene and patient care: Pursuing the Semmelweis legacy. The Lancet Infectious Diseases, 1(1), 9–20. DOI: https://doi.org/10.1016/S1473-3099(09)70295-6
Tamma, P. D., Aitken, S. L., Bonomo, R. A., & Mathers, A. J. (2021). Multidrug-resistant gram-negative bacteria: Epidemiology and management. Clinical Infectious Diseases, 72(11), 1995–2004.
Vestal, G. (2017). Hospital antibiotic stewardship programs. Antibiotics, 6(4), 36.
Schuts, E. C., Hulscher, M. E. J. L., Mouton, J. W., Verduin, C. M., Stuart, J. W., Overdiek, H. W. P. M., & Natsch, S. (2016). Current evidence on hospital antimicrobial stewardship objectives: A systematic review and meta-analysis. The Lancet Infectious Diseases, 16(7), 847–856. DOI: https://doi.org/10.1016/S1473-3099(16)00065-7
Dellit, T. H., Owens, R. C., McGowan, J. E., Gerding, D. N., Weinstein, R. A., Burke, J. P., & Hooton, T. M. (2007). Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clinical Infectious Diseases, 44(2), 159–177.
Barlam, T. F., Cosgrove, S. E., Abbo, L. M., MacDougall, C., Schuetz, A. N., Septimus, E. J., & Weber, D. J. (2016). Implementing an antibiotic stewardship program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clinical Infectious Diseases, 62(10), e51–e77.
Tamma, P. D., Aitken, S. L., Bonomo, R. A., & Mathers, A. J. (2021). Multidrug-resistant gram-negative bacteria: Epidemiology and management. Clinical Infectious Diseases, 72(11), 1995–2004.
Dyar, O. J., Obua, C., Chandy, S., Xiao, Y., Stålsby Lundborg, C., & Pulcini, C. (2016). Using antibiotics responsibly: Are we there yet? BMJ Global Health, 1(3), e000091. DOI: https://doi.org/10.2217/fmb-2016-0041
Nicolle, L. E., Gupta, K., & Bradley, S. F. (2020). Antimicrobial stewardship in long-term care facilities. Clinical Infectious Diseases, 70(11), 1973–1981.
Goff, D. A., Kullar, R., Bauer, K. A., File, T. M., Zervos, M. J., & Hermsen, E. D. (2017). Eight habits of highly effective antimicrobial stewardship programs to meet the joint commission standards for hospitals. Clinical Infectious Diseases, 64(8), 1134–1139.
Lee, T. C., Zvonar, R. K., & Nickerson, A. (2014). Antibiotic stewardship: Future directions. Canadian Journal of Hospital Pharmacy, 67(5), 388–394.
Rawson, T. M., Moore, L. S. P., Castro-Sánchez, E., Charani, E., Davies, F., & Holmes, A. H. (2020). COVID-19 and antimicrobial resistance. Journal of Antimicrobial Chemotherapy, 75(7), 1681–1690.
Interprofessional Education Collaborative (IPEC). (2016). Core competencies for interprofessional collaborative practice: 2016 update. Washington, DC: IPEC.
Reeves, S., Fletcher, S., Barr, H., Birch, I., Boet, S., Davies, N., & Kitto, S. (2016). A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39. Medical Teacher, 38(7), 656–668. DOI: https://doi.org/10.3109/0142159X.2016.1173663
O’Brien, M. A., Rogers, S., Jamtvedt, G., Oxman, A. D., Odgaard-Jensen, J., Kristoffersen, D. T., & Straus, S. E. (2018). Educational outreach visits: Effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 9(4), CD000409.
Ashiru-Oredope, D., Sharland, M., Charani, E., McNulty, C., & Cooke, J. (2012). Improving the quality of antibiotic prescribing in the NHS by developing a new antimicrobial stewardship program: Start Smart—Then Focus. Journal of Antimicrobial Chemotherapy, 67(suppl_1), i51–i63. DOI: https://doi.org/10.1093/jac/dks202
Baysari, M. T., Lehnbom, E. C., Li, L., & Westbrook, J. I. (2016). The effectiveness of information technology to improve antimicrobial prescribing in hospitals: A systematic review and meta-analysis. International Journal of Medical Informatics, 92, 15–34.
Garau, J., Bassetti, M., & Peghin, M. (2018). Hospital antimicrobial stewardship (AMS) programs in critically ill patients. Current Opinion in Infectious Diseases, 31(4), 420–427.
Dellit, T. H., Owens, R. C., McGowan, J. E., Gerding, D. N., Weinstein, R. A., Burke, J. P., & Hooton, T. M. (2007). Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clinical Infectious Diseases, 44(2), 159–177. DOI: https://doi.org/10.1086/510393
Goff, D. A., Kullar, R., Bauer, K. A., File, T. M., Zervos, M. J., & Hermsen, E. D. (2017). Eight habits of highly effective antimicrobial stewardship programs to meet the joint commission standards for hospitals. Clinical Infectious Diseases, 64(8), 1134–1139. DOI: https://doi.org/10.1093/cid/cix065
Rawson, T. M., Moore, L. S. P., Castro-Sánchez, E., Charani, E., Davies, F., & Holmes, A. H. (2020). COVID-19 and antimicrobial resistance. Journal of Antimicrobial Chemotherapy, 75(7), 1681–1690. DOI: https://doi.org/10.1093/jac/dkaa194
Nicolle, L. E., Gupta, K., & Bradley, S. F. (2020). Antimicrobial stewardship in long-term care facilities. Clinical Infectious Diseases, 70(11), 1973–1981.
Klein, E. Y., Van Boeckel, T. P., Martinez, E. M., Pant, S., Gandra, S., Levin, S. A., & Laxminarayan, R. (2018). Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. PNAS, 115(15), E3463–E3470. DOI: https://doi.org/10.1073/pnas.1717295115
Monaghesh, E., & Hajizadeh, A. (2020). The role of telehealth during COVID-19 outbreak: A systematic review. BMC Public Health, 20(1), 1–9. DOI: https://doi.org/10.1186/s12889-020-09301-4
Ashiru-Oredope, D., Hopkins, S., Vasandani, S., Umoh, E., Oloyede, O., Nilsson, A., & Kinsman, J. (2016). Improving engagement in antimicrobial stewardship: A practice-based approach. Journal of Antimicrobial Chemotherapy, 71(11), 2883–2891.
Australian Commission on Safety and Quality in Health Care (ACSQHC). (2019). Antimicrobial Stewardship Clinical Care Standard. Sydney: ACSQHC.
European Centre for Disease Prevention and Control (ECDC). (2020). Antimicrobial resistance surveillance in Europe 2020. ECDC Annual Report.
Cosgrove, S. E., & Carmeli, Y. (2003). The impact of antimicrobial resistance on health and economic outcomes. Clinical Infectious Diseases, 36(11), 1433–1437. DOI: https://doi.org/10.1086/375081
Ling, M. L., Apisarnthanarak, A., & Madriaga, G. (2015). The burden of healthcare-associated infections in Southeast Asia: A systematic literature review and meta-analysis. Clinical Infectious Diseases, 60(11), 1690–1699. DOI: https://doi.org/10.1093/cid/civ095
Tacconelli, E., Carrara, E., Savoldi, A., Harbarth, S., Mendelson, M., Monnet, D. L., & Rice, L. B. (2018). Discovery, research, and development of new antibiotics: The WHO priority list of antibiotic-resistant bacteria and tuberculosis. The Lancet Infectious Diseases, 18(3), 318–327.
Barlam, T. F., Cosgrove, S. E., Abbo, L. M., MacDougall, C., Schuetz, A. N., Septimus, E. J., & Weber, D. J. (2016). Implementing an antibiotic stewardship program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clinical Infectious Diseases, 62(10), e51–e77. DOI: https://doi.org/10.1093/cid/ciw118
Laxminarayan, R., Matsoso, P., Pant, S., Brower, C., Røttingen, J. A., Klugman, K., & Davies, S. (2016). Access to effective antimicrobials: A worldwide challenge. The Lancet, 387(10014), 168–175. DOI: https://doi.org/10.1016/S0140-6736(15)00474-2
O’Brien, M. A., Rogers, S., Jamtvedt, G., Oxman, A. D., Odgaard-Jensen, J., Kristoffersen, D. T., & Straus, S. E. (2018). Educational outreach visits: Effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 9(4), CD000409.
Baysari, M. T., Lehnbom, E. C., Li, L., & Westbrook, J. I. (2016). The effectiveness of information technology to improve antimicrobial prescribing in hospitals: A systematic review and meta-analysis. International Journal of Medical Informatics, 92, 15–34. DOI: https://doi.org/10.1016/j.ijmedinf.2016.04.008
Garau, J., Bassetti, M., & Peghin, M. (2018). Hospital antimicrobial stewardship (AMS) programs in critically ill patients. Current Opinion in Infectious Diseases, 31(4), 420–427. DOI: https://doi.org/10.1097/QCO.0000000000000438
Published
How to Cite
Issue
Section
Copyright (c) 2022 International journal of health sciences

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.