Clinical and economic outcomes of a prospective antimicrobial stewardship program.
نویسندگان
چکیده
PURPOSE A pre-post analysis of an antimicrobial stewardship program (ASP) involving the use of data-mining software to prospectively identify cases for ASP intervention was conducted. METHODS The investigators evaluated clinical outcomes and cost metrics before and after implementation of the ASP, which entailed daily physician review of summary reports on all adult inpatients receiving antimicrobial therapy. The primary outcome measures were annual antimicrobial expenditures and rates of infections due to common nosocomial pathogens; secondary outcome measures included patient survival and length of stay (LOS) in cases involving the indicator diagnoses of pneumonia and abdominal sepsis. RESULTS Antimicrobial expenditures, which had increased by an average of 14.4% annually in the years preceding ASP implementation, decreased by 9.75% in the first year of the program and remained relatively stable in subsequent years, with overall cumulative cost savings estimated at $1.7 million. Rates of nosocomial infections involving Clostridium difficile, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant enterococci all decreased after ASP implementation. A pre-post comparison of survival and LOS in patients with pneumonia (n = 2186) or abdominal sepsis (n = 225) showed no significant differences in those outcomes in either patient group, possibly due to the hospital's initiation of other, concurrent infection-control programs during the study period. CONCLUSION A prospective collaborative ASP employed automated reports to efficiently identify key data for ASP review. After ASP implementation, antimicrobial expenditures and rates of nosocomial infections caused by resistant pathogens dropped without significant changes in patient survival, LOS, and readmissions for the two studied illness categories.
منابع مشابه
Economic and Clinical Outcomes of Antimicrobial Stewardship Program Implementation at a Community Hospital Affiliated with a Regional Health System
متن کامل
Inpatient Antimicrobial Stewardship in Pediatrics: A Systematic Review.
BACKGROUND The clinical and economic outcomes associated with pediatric antimicrobial stewardship programs (ASPs) and other supplemental antimicrobial stewardship (AS) interventions have not been well described or reviewed. METHODS We performed a systematic review using PubMed to identify studies with any of the following terms in the title or abstract: "antimicrobial stewardship," "antimicro...
متن کاملAntibiotic Prescribing Trends Before and After Implementation of an Audit and Feedback Program in Internal ward of a Tertiary Hospital in Tehran
We implemented a post prescribing review and feedback program to investigate its effect on appropriateness of antimicrobial use and antimicrobial consumption rate.A pre-post interventional study conducted in internal ward of Imam Hossein teaching hospital. For nine months of intervention phase, medical file of all patients who received intravenous antibiotic were reviewed by a clinical ph...
متن کاملAntibiotic Prescribing Trends Before and After Implementation of an Audit and Feedback Program in Internal ward of a Tertiary Hospital in Tehran
We implemented a post prescribing review and feedback program to investigate its effect on appropriateness of antimicrobial use and antimicrobial consumption rate.A pre-post interventional study conducted in internal ward of Imam Hossein teaching hospital. For nine months of intervention phase, medical file of all patients who received intravenous antibiotic were reviewed by a clinical ph...
متن کاملImpact of a Prospective Audit and Feedback Antimicrobial Stewardship Program at a Veterans Affairs Medical Center: A Six-Point Assessment
BACKGROUND Prospective audit and feedback is a core antimicrobial stewardship program (ASP) strategy; however its impact is difficult to measure. METHODS Our quasi-experimental study measured the effect of an ASP on clinical outcomes, antimicrobial use, resistance, costs, patient safety (adverse drug events [ADE] and Clostridium difficile infection [CDI]), and process metrics pre- (9/10-10/11...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
دوره 69 17 شماره
صفحات -
تاریخ انتشار 2012