{
  "abstract": "Background and Importance Antimicrobial stewardship programs (ASP) are widely recognised as essential interventions in combating resistant bacteria. However, comparability of their impact remains challenging. This issue is particularly concerning in systematic reviews, which represent high-level evidence and play a crucial role in policy and practice decisions.Aim and Objectives The aim of this study is to describe the reported outcomes in reviews on ASP interventions.Material and Methods An umbrella review was conducted. Searches were performed using PubMed,Scopus, Cochrane Library, and Google Scholar databases from inception to May 2024, with peer-based data screening, collection and quality assessment using the modified AMSTAR-2 (MeaSurement Tool to Assess systematic Reviews) tool. Study protocol: osf.io/qy9r5. PRISMA-ScR procedure was applied.Results From 1208 citations, 1099 reviews were eligible for inclusion summarising a total of 54 articles. Hard outcome, such as mortality, was reported in 35 (64,8%) reviews, with 8 (14,8%) in-hospital mortality, 6 (11,1%) specifying 30-day mortality, 5 (9,2%) all-cause mortality, 3 (5,5%) ICU mortality, 2 (3,7%) 15-day mortality, and in 19 (35,2%) reviews the type of mortality was not specified. Only 14 (25,9%) of the reviews identified studies where a significant reduction in mortality was observed, while the remaining reviews reported that the intervention was not significantly associated with changes in mortality. Readmission rates were reported in 11 (20,4%) and length of stay 31 (57,4%) were adherence to guidelines and adverse events respectively were citated in15 (27,4%), 9 (16,7%), 16 (29,6%). However, no statement on patient and public involvement was identified in the reviews. High inconsistences across other outcomes definition and measures related to prescription appropriateness or process indicators were identified. The overall quality was low or critically low 50 (92,6%) and only 2 reviews (3,7%) were classified as high quality. The most loss-making domains involve the lack of measuring the risk of bias (RoB) with an appropriate tool or to explicitly state that review methods were previously established among others.Conclusion and Relevance To assess the real impact of ASP interventions, the quality and comparability of the studies need to improve. Future research should focus on harmonising outcomes definitions and foster research integrity aspects.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "University Hospital Germans Trias I Pujol, Hospital Pharmacy, Badalona, Spain"
      ],
      "name": "I García-Giménez"
    },
    {
      "affiliations": [
        "San Cecilio University Hospital, Hospital Pharmacy, Granada, Spain"
      ],
      "name": "MR Robles-Muñoz"
    },
    {
      "affiliations": [
        "San Cecilio University Hospital, Hospital Pharmacy, Granada, Spain"
      ],
      "name": "MÁ Urbano Fernández"
    },
    {
      "affiliations": [
        "San Cecilio University Hospital, Hospital Pharmacy, Granada, Spain"
      ],
      "name": "M Nuñez Nuñez"
    },
    {
      "affiliations": [
        "University of Granada, Preventive Medicine and Public Health, Granada, Spain"
      ],
      "name": "A Bueno-Cavanillas"
    },
    {
      "affiliations": [
        "San Cecilio University Hospital, Hospital Pharmacy, Granada, Spain"
      ],
      "name": "J Cabeza Barrera"
    }
  ],
  "title": "6ER-047 Towards comparable outcomes in antimicrobial stewardship studies",
  "uid": "34019d1d-ce18-5b05-9fe9-267acddce559"
}