A little nudge goes a long way: assessing the impact of a microbiology nudge comment on narrow-spectrum antibiotic use in uncomplicated Streptococcus pneumoniae bloodstream infections

Narrow-spectrum antibiotic prescribing (ampicillin IV or penicillin IV) was compared before and after implementing an interpretive microbiology comment for uncomplicated Streptococcus pneumoniae bloodstream infections. The postintervention group was associated with 4-fold increased odds of de-escalation to narrow-spectrum antibiotics (adjusted odds ratio, 4.66; 95% confidence interval, 1.97-11.00).