Table 1.
AMS intervention in the pre- and post-COVID-19 pandemic eras.
| Interventions | Pre-COVID-19 | During COVID-19 | Post-COVID-19 |
|---|---|---|---|
| Educational programmes | Face-to-face Passive Active Public campaigns |
Mobile technology (apps) Video conferencing Public campaigns on hospital website |
Integration of pre- and during COVID-19 interventions |
| ASP staff training | Face-to-face conferencing | Video conferencing | Integration of pre- and during COVID-19 interventions |
| Audit and feedback | Meetings and gatherings | Video conferencing E-mails |
Integration of pre- and during COVID-19 interventions |
| Restriction and pre-authorization | Monitoring antimicrobial consumption and limiting the use of broad-spectrum antibiotics | Monitoring drug shortages Literature updated with evidence on the real impact of coinfection and superinfection |
Implementation of electronic restriction and pre-authorization with the help of pharmacists |
| Guidelines and protocols | Paper guidelines | Apps/e-mails | Implementation of app software (easier to update with the constant new release of literature) |
| Microbiology | Interpretation of antibiotic susceptibility
tests Interpretation of results (i.e. colonization versus infection) De-escalation and IV-to-oral conversion |
Implementation of web-based alert system for MDR or C.
difficile
De-escalation to stop antibiotics and IV-to-oral conversion Early switch, when feasible, to oral to facilitate discharge. Removal of antivirals and airborne and contact precautions when SARS-COV-2 testing turns negative |
Implementation of rapid diagnostic tests, especially of upper respiratory samples |
| Diagnostic stewardship | Appropriateness of sampling for microbiology Assist diagnosis in order to run high pre-test probability tests Correct interpretation of results |
Running different tests (molecular, antigenic, serologic) in
high COVID-19 suspicion cases with first negative
test Using appropriate upper respiratory sample to make an alternative diagnosis (i.e. influenza virus or RSV) Stop running molecular SARS-COV-2 tests in patients with a recent history of COVID-19 infection presenting with dyspnoea |
Integration of pre- and during COVID-19 interventions |
IV, intravenous; MDR, multidrug-resistant; RSV, respiratory syncytial virus; SARS-COV-2, severe acute respiratory syndrome coronavirus 2.