Establishing an effective antimicrobial stewardship program at four secondary-care hospitals in India using a hub-and-spoke model.

Antibiotic-related adverse events and overall mortality were similar in both groups in our study, but infection-related mortality showed a trend toward favorable outcome in the postintervention group compared to the baseline group (43.8% vs 61%; P = .193), suggesting that optimizing antibiotic therapy does not lead to poor outcomes.

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Also, the rate of antibiotic de-escalation was significantly higher in the postintervention phase than the baseline phase (44% vs 12.5%; P < .0001), which suggests a definite trend toward judicious use of antibiotics.

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