Long-term outcomes of an electronic medical record (EMR)–integrated antimicrobial stewardship (AMS) intensive care unit (ICU) ward round

To the Editor — Intensive care units (ICUs) are an important target for antimicrobial stewardship (AMS) programs due to their high usage of antimicrobials. 1,2 Audit and feedback, with face-to-face education within the ICU is associated with a short-term decrease in antimicrobial consumption, beneficial effects on resistance rates, and a reduction in antimicrobial costs. 3-6 We previously demonstrated the impact of an EMR-integrated AMS-ICU ward round over a 9-month period. 7 In this current study, we have demonstrated the long-term ( > 12 months) sustained improvement in antimicrobial prescribing following the implementation of an EMR-integrated AMS-ICU ward round. Additionally, we explored clinical and patient factors that affect the decision to provide AMS recommendations.InAugust2017, a new 5-day-per-week, EMR-integrated, AMS-ICU ward round was implemented at Austin Health (Melbourne, Australia), a tertiary referral hospital with a 29-bed mixed medical-surgical ICU. 7 From August 2017 to July 2019 (inclusive), we aud-ited the results of