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Antimicrobial Stewardship — SCE Infectious Diseases MCQ

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EasyAntimicrobial StewardshipAntimicrobial StewardshipSCE Infectious Diseases

A hospital antibiotic stewardship team is implementing a carbapenem-sparing strategy. Which of the following antimicrobial stewardship interventions has the strongest evidence base for reducing inappropriate broad-spectrum antibiotic use?

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Correct answer: C — Prospective audit with feedback by an antimicrobial stewardship team

NICE NG15 (2015, updated 2024) and CDC stewardship guidance identify prospective audit with feedback (also called post-prescription review) as one of the two core stewardship strategies with the strongest evidence base (alongside formulary restriction with pre-authorisation). Prospective audit allows clinicians to prescribe empirically and then receives expert pharmacist/microbiologist feedback to optimise therapy (de-escalation, duration, IV-to-oral switch). It is more acceptable to clinicians than restrictive approaches and reduces broad-spectrum use without compromising outcomes.

Reference: NICE NG15 2015 (updated 2024) – Antimicrobial stewardship; BSAC 2023 – Stewardship toolkit