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Conclusions
Research to date has established that ASPs including audit and feedback, guideline implementation, and decision support improve prescribing and microbial outcomes without significant adverse impact on patient outcomes. Comparative effectiveness, sustainability, and scalability of different approaches are not known. Future research should include multicenter studies across large healthcare systems to advance knowledge beyond the existing evidence base from small, often single-site, studies that have focused on antimicrobial outcomes. Nevertheless, the current state of knowledge is sufficient to make stewardship implementation a priority in all hospitals, especially given the emerging threat of resistance.
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