side-effects, increased costs, and prolonged hospital stays.3 Therefore,
antimicrobial stewardship to improve the adequacy of antibiotic
use is of great importance, and various strategies for antimicrobial
stewardship have been devised.3 Prospective audit and feedback
is an effective measure,4-6 but its requirement of having dedicated
infectious disease physicians limits its application in many areas of
the world. Education is the most frequently used intervention, but
its effect is marginal and short-lived by itself.2,7,8 Restrictive measures
can result in the unexpected squeezing the balloon effect
although they are most effective and easily applicable.9 Therefore,
more effective options are urgently needed to overcome the intrinsic
difficulty of modifying the physicians’ behavior, which leads to
significant and sustained impacts on antibiotic use.