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AHRQ Technical Reviews and Summaries
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 9.v.4:  Closing the Quality Gap: Antibiotic Prescribing Behavior

A21647

Full Title: Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies: Volume 4—Antibiotic Prescribing Behavior

Prepared for:

Agency for Healthcare Research and Quality

U.S. Department of Health and Human Services

540 Gaither Road

Rockville, MD 20850

www.ahrq.gov

Contract No. 290-02-0017

Prepared by:

Stanford-UCSF Evidence-based Practice Center

Series Editors

  • Kaveh G. Shojania, M.D., University of California, San Francisco

  • Kathryn M. McDonald, M.M., Stanford University

  • Robert M. Wachter, M.D., University of California, San Francisco

  • Douglas K. Owens, M.D., M.S., VA Palo Alto Health Care System, Palo Alto, California Stanford University

Managing Editor

  • Amy J. Markowitz, J.D.

Investigators

  • Sumant R. Ranji, M.D.

  • Michael A. Steinman, M.D.

  • Kaveh G. Shojania, M.D.

  • Vandana Sundaram, M.P.H.

  • Robyn Lewis, M.A.

  • Sandra Arnold, M.D., M.S.

  • Ralph Gonzales, M.D., M.S.P.H.

AHRQ Publication No. 04(06)-0051-4

January 2006

This report is based on research conducted by the Stanford-UCSF Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-02-0017). The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment.

This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted for which further reproduction is prohibited without the specific permission of copyright holders.

Suggested Citation:

Ranji SR, Steinman MA, Shojania KG, Sundaram V, Lewis R, Arnold S, Gonzales R. Antibiotic Prescribing Behavior. Vol. 4 of: Shojania KG, McDonald KM, Wachter RM, Owens DK, editors. Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies. Technical Review 9 (Prepared by the Stanford University-UCSF Evidence-based Practice Center under Contract No. 290-02-0017). AHRQ Publication No. 04(06)-0051-4. Rockville, MD: Agency for Healthcare Research and Quality. January 2006.

None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.

Full Title: Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies: Volume 4—Antibiotic Prescribing Behavior

Prepared for:

Agency for Healthcare Research and Quality

U.S. Department of Health and Human Services

540 Gaither Road

Rockville, MD 20850

www.ahrq.gov

Contract No. 290-02-0017

Prepared by:

Stanford-UCSF Evidence-based Practice Center

Series Editors

  • Kaveh G. Shojania, M.D., University of California, San Francisco

  • Kathryn M. McDonald, M.M., Stanford University

  • Robert M. Wachter, M.D., University of California, San Francisco

  • Douglas K. Owens, M.D., M.S., VA Palo Alto Health Care System, Palo Alto, California Stanford University

Managing Editor

  • Amy J. Markowitz, J.D.

Investigators

  • Sumant R. Ranji, M.D.

  • Michael A. Steinman, M.D.

  • Kaveh G. Shojania, M.D.

  • Vandana Sundaram, M.P.H.

  • Robyn Lewis, M.A.

  • Sandra Arnold, M.D., M.S.

  • Ralph Gonzales, M.D., M.S.P.H.

AHRQ Publication No. 04(06)-0051-4

January 2006

This report is based on research conducted by the Stanford-UCSF Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-02-0017). The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment.

This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted for which further reproduction is prohibited without the specific permission of copyright holders.

Suggested Citation:

Ranji SR, Steinman MA, Shojania KG, Sundaram V, Lewis R, Arnold S, Gonzales R. Antibiotic Prescribing Behavior. Vol. 4 of: Shojania KG, McDonald KM, Wachter RM, Owens DK, editors. Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies. Technical Review 9 (Prepared by the Stanford University-UCSF Evidence-based Practice Center under Contract No. 290-02-0017). AHRQ Publication No. 04(06)-0051-4. Rockville, MD: Agency for Healthcare Research and Quality. January 2006.

None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.

Contents

Preface

Acknowledgments

Structured Abstract

Executive Summary

Chapter 1. Introduction

Chapter 2. Methods

Chapter 3. Results

Chapter 4. Discussion

Summary Tables

Appendix A. Summary of Key Studies

Appendix B. Summaries of Included Studies, Grouped by Setting and Measured Population

Appendix C. EPOC and Medline Search for Antibiotic QI Articles

Appendix D. Antibiotic Abstraction Forms for Screening and Full-Text Review

Appendix E. Random Effects Meta-Analysis of Included Trials

Appendix F. Technical Expert Panel and Peer Reviewers

References

Listing of Excluded Studies

Table References

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