Table 3. Main antimicrobial stewardship strategies recommended in the international literature to improve antibiotic use at the hospital level.^1,49.

Educational measures and active interventions
Passive educational measures	• Developing/updating local antibiotic guidelines • Educational sessions, workshops, local conferences
Active interventions	• Clinical rounds discussing cases • Prospective audit with intervention and feedback • Reassessment of antibiotic prescriptions, with streamlining and de-escalation of therapy • Academic detailing, educational outreach visits
Restrictive measures	• Limiting number of antibiotics on the hospital formulary • Antibiotic order form (compulsory) • Automatic stop order • Formulary restriction and preauthorization • Limiting reporting of susceptibilities by the microbiology laboratory • Regulating contacts with the pharmaceutical industry
Supportive/supplemental measures	• Multidisciplinary antimicrobial stewardship team • Consultancy service (infectious diseases, pharmacy, microbiology) • Computer-assisted management program • Parenteral to oral conversion • Therapeutic drug monitoring service