Cargando…
Opportunities and challenges in improving antimicrobial use during the era of telehealth expansion: A narrative review
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 aven...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495641/ https://www.ncbi.nlm.nih.gov/pubmed/36168461 http://dx.doi.org/10.1017/ash.2021.191 |
_version_ | 1784794068918730752 |
---|---|
author | Suzuki, Hiroyuki Shealy, Stephanie C. Throneberry, Kyle Stenehjem, Edward Livorsi, Daniel |
author_facet | Suzuki, Hiroyuki Shealy, Stephanie C. Throneberry, Kyle Stenehjem, Edward Livorsi, Daniel |
author_sort | Suzuki, Hiroyuki |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9495641 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-94956412022-09-26 Opportunities and challenges in improving antimicrobial use during the era of telehealth expansion: A narrative review Suzuki, Hiroyuki Shealy, Stephanie C. Throneberry, Kyle Stenehjem, Edward Livorsi, Daniel Antimicrob Steward Healthc Epidemiol Review 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. Cambridge University Press 2021-10-06 /pmc/articles/PMC9495641/ /pubmed/36168461 http://dx.doi.org/10.1017/ash.2021.191 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Suzuki, Hiroyuki Shealy, Stephanie C. Throneberry, Kyle Stenehjem, Edward Livorsi, Daniel Opportunities and challenges in improving antimicrobial use during the era of telehealth expansion: A narrative review |
title | Opportunities and challenges in improving antimicrobial use during the era of telehealth expansion: A narrative review |
title_full | Opportunities and challenges in improving antimicrobial use during the era of telehealth expansion: A narrative review |
title_fullStr | Opportunities and challenges in improving antimicrobial use during the era of telehealth expansion: A narrative review |
title_full_unstemmed | Opportunities and challenges in improving antimicrobial use during the era of telehealth expansion: A narrative review |
title_short | Opportunities and challenges in improving antimicrobial use during the era of telehealth expansion: A narrative review |
title_sort | opportunities and challenges in improving antimicrobial use during the era of telehealth expansion: a narrative review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495641/ https://www.ncbi.nlm.nih.gov/pubmed/36168461 http://dx.doi.org/10.1017/ash.2021.191 |
work_keys_str_mv | AT suzukihiroyuki opportunitiesandchallengesinimprovingantimicrobialuseduringtheeraoftelehealthexpansionanarrativereview AT shealystephaniec opportunitiesandchallengesinimprovingantimicrobialuseduringtheeraoftelehealthexpansionanarrativereview AT throneberrykyle opportunitiesandchallengesinimprovingantimicrobialuseduringtheeraoftelehealthexpansionanarrativereview AT stenehjemedward opportunitiesandchallengesinimprovingantimicrobialuseduringtheeraoftelehealthexpansionanarrativereview AT livorsidaniel opportunitiesandchallengesinimprovingantimicrobialuseduringtheeraoftelehealthexpansionanarrativereview |