Outcomes associated with a thrice-weekly antimicrobial stewardship programme in a 253-bed community hospital

J Clin Pharm Ther. 2013 Oct;38(5):401-4. doi: 10.1111/jcpt.12079. Epub 2013 Jul 12.

Abstract

What is known and objectives: Antimicrobial stewardship programmes (ASPs) have been shown to decrease antimicrobial resistance, reduce hospital-acquired infections and decrease overall antimicrobial expenditures. At St. Joseph Medical Center in Bellingham, WA, a thrice-weekly ASP was initiated in 2010 with the goals of decreasing carbapenem, fluoroquinolone and vancomycin use and tailoring duration of therapy.

Methods: Antibiotic use per 1000 patient-days and carbapenem, fluoroquinolone and vancomycin use were evaluated pre- and post-implementation of the ASP. Total antimicrobial expenditures were evaluated for the 3 years prior to ASP implementation and three years following implementation.

Results and discussion: Antimicrobial days of therapy per 1000 patient-days declined by 6·4% after implementation of our ASP. There was a 37% reduction in total antimicrobial expenditures after implementation. Carbapenems, vancomycin and levofloxacin use decreased considerably. Ciprofloxacin use increased during the same time period.

What is new and conclusion: A thrice-weekly, pharmacist-driven ASP can decrease antimicrobial expenditure, shorten duration of therapy and decrease the utilization of carbapenems, vancomycin and levofloxacin.

Keywords: antibiotics; clinical pharmacy; costs; hospital; pharmacy practice; prescribing patterns.

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / economics
  • Carbapenems / administration & dosage
  • Cross Infection / prevention & control
  • Drug Resistance, Bacterial
  • Fluoroquinolones / administration & dosage
  • Hospitals, Community / economics
  • Hospitals, Community / methods
  • Hospitals, Community / organization & administration
  • Humans
  • Retrospective Studies
  • Vancomycin / administration & dosage

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Fluoroquinolones
  • Vancomycin