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Decrease in expenditures and selected nosocomial infections following implementation of an antimicrobial-prescribing

M O Frank1, B E Batteiger, S J Sorensen

  • 1Indiana University School of Medicine, Indianapolis 46202, USA.

Clinical Performance and Quality Health Care
|September 4, 1997
PubMed
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Implementing an antimicrobial stewardship program significantly reduced antimicrobial use and healthcare costs. This initiative also led to a decrease in hospital-acquired infections caused by resistant bacteria.

Area of Science:

  • Infectious Diseases
  • Hospital Administration
  • Public Health

Background:

  • Antimicrobial resistance is a growing global health threat.
  • Hospital-acquired infections (HAIs) contribute significantly to morbidity and mortality.
  • Effective antimicrobial stewardship programs (ASPs) are crucial for combating resistance and improving patient outcomes.

Purpose of the Study:

  • To assess the impact of an antimicrobial-prescribing improvement program on antimicrobial consumption and expenditures.
  • To evaluate the effect of the program on the incidence of specific nosocomial infections caused by resistant organisms.

Main Methods:

  • A before-and-after trial design was employed, comparing data from 1992 (pre-program) to 1994 (post-program implementation).
  • The study was conducted at an academic medical center, encompassing all patients and physicians.

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  • The intervention involved an antimicrobial-prescribing improvement program with a prior approval requirement for restricted antimicrobial agents.

    • Main Results:

    • Antimicrobial use decreased from 158,107 to 137,364 defined daily doses between 1992 and 1994.
    • Expenditures for antimicrobials dropped from $2,486,902 to $1,701,522, with estimated savings of $279,573 in 1993 and $389,814 in 1994.
    • Significant reductions were observed in rates of enterococcal bacteremia, gram-negative bacteremia, methicillin-resistant Staphylococcus aureus (MRSA), and Stenotrophomonas infections.

    Conclusions:

    • The implementation of an antimicrobial-prescribing improvement program resulted in substantial cost savings.
    • The program was associated with significant decreases in the incidence of key nosocomial infections caused by resistant pathogens.
    • These findings underscore the effectiveness of structured antimicrobial stewardship in healthcare settings.