Spread and Sustainability of an Antimicrobial Stewardship Initiative Within a Pediatric Network

Projects employing performance feedback with education have been used to improve antimicrobial prescribing practices, but improvements may not be sustainable after the active intervention. We sought to determine whether ongoing clinical decision support (CDS) could sustain improvements achieved through initial feedback and education in prescribing shorter durations of treatment for skin and soft tissue infections (SSTI).

As a follow-up to a site-randomized trial, we provided performance feedback and education for 3 months along with an ongoing CDS alert operating at the point of care within a large statewide cohort of pediatricians. Following the initial period of feedback and education, we continued to deploy the alert and monitored outcomes over a 24-month period.