We thank Charis Marwick and colleagues and Céline Pulcini and Peter Collignon for their comments on our study.¹ As stated in the Discussion section, we completely agree that the possibility of uncontrolled studies having observed effects as a result of an underlying secular trend cannot be ignored, and we also recommended the use of controlled interventional designs for future studies. However, we would like to underline that, although some guidance is available on how to design interventions on antimicrobial stewardship,² specific recommendations about how to select study designs and overcome major bias in assessing antibiotic stewardship programmes (eg, definitions of outcomes or analytical methods) are missing or under development.

中文翻译：

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医院抗菌管理：前进的方向–作者的回复

我们感谢Charis Marwick及其同事以及CélinePulcini和Peter Collignon对我们的研究发表的评论。¹如“讨论”部分所述，我们完全同意，不可忽视的研究可能会因潜在的长期趋势而产生观察到的影响，因此，我们还建议在未来的研究中使用受控的干预性设计。然而，我们想强调的是，尽管有一些关于如何设计抗微生物药物管理干预措施的指南，但有^2条关于如何选择研究设计并克服评估抗生素管理项目的主要偏见的具体建议（例如，结果的定义或分析方法） ）丢失或正在开发中。