Fridkin 2002.

Methods	STUDY DESIGN: CBA Risk of Bias: HIGH
Participants	PROVIDERS: a total of 50 ICUs located in 20 hospitals PARTICIPANTS: patients in the ICU CLINICAL PROBLEM: vancomycin use, prevalence of VRE SETTING: hospitals in the USA participating in the ICU surveillance component of National Nosocomial Infection Surveillance
Interventions	FORMAT: 5 interventions were used by 3 to 19 hospitals (some hospitals used more than 1). 3 interventions were hospital‐wide and 2 were unit‐specific. Hospital‐wide interventions (22 ICUs) Intervention 1: educational meetings with dissemination of educational materials, 9 ICUs. Intervention function: education. Intervention 2: audit and feedback, 19 ICUs. Intervention function: enablement. Intervention 3: restriction, 3 ICUs. Intervention function: restriction. Unit‐specific interventions (11 ICUs) Intervention 4: educational meetings with dissemination of educational materials. Intervention function: education. Intervention 5: restriction, 3 ICUs. Intervention function: restriction. DELIVERER: AMT COMPARISON: national benchmark data DESIRED CHANGE: decrease excessive
Outcomes	PRESCRIBING: Choice: DDDs of vancomycin MICROBIAL: percentages of VRE and MRSA
Notes	FINANCIAL SUPPORT: Funding: CDC Emerging Infections Program. Competing Interests: no information ADDITIONAL DATA: email response from authors but no additional data
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	CBA ‐ not randomised
Allocation concealment (selection bias)	High risk	CBA ‐ not randomised
Blinding (performance bias and detection bias) All outcomes	High risk	CBA, allocation not blinded
Incomplete outcome data (attrition bias) All outcomes	Low risk	Not clear: “Susceptibility reports from isolates obtained as part of infection‐control surveillance were excluded.” Criteria for exclusion of isolates are not described and may not have been consistent across all hospitals.
Selective reporting (reporting bias)	Low risk	Not clear: “Susceptibility reports from isolates obtained as part of infection‐control surveillance were excluded.” Criteria for exclusion of isolates are not described and could have led to reporting bias.
Other bias	Unclear risk	NOT CLEAR Microbial Risk of Bias Criteria: Case definition: percentage VRE or percentage MRSA in clinical isolates; Planned intervention: DONE; Other infection control isolation: NOT CLEAR; IC practices: NOT CLEAR Data were collected about infection control changes in response to feedback of data, but the paper does not report any results.
Baseline Outcomes similar?	Unclear risk	Not stated
Free of contamination?	Low risk	Interventions were at different hospitals from control sites.
Baseline characteristics similar?	Unclear risk	Not stated