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[Evaluation of an advisory program in antibiotic therapy]
J Cobo Reinoso1, J Oliva Domínguez, M Soler Vigil
1Servicios de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, Spain. jcobo@hrc.insalud.es
Revista Clinica Espanola
|May 9, 2002
Summary
An antibiotic control program (ACP) guided by infectious disease specialists effectively reduced antibiotic costs and the incidence of hospital-acquired infections like MRSA and Clostridium difficile. This program demonstrated positive outcomes without negatively impacting patient mortality or readmission rates.
Area of Science:
- Infectious Diseases
- Hospital Administration
- Antimicrobial Stewardship
Context:
- Rising microbial resistance and escalating pharmaceutical costs necessitate effective antibiotic control programs (ACPs).
- Optimal design and implementation of ACPs remain subjects of debate within healthcare settings.
- This study evaluated an ACP based on infectious diseases specialist recommendations.
Purpose:
- To assess the impact of an infectious diseases specialist-driven ACP on antibiotic costs, patient outcomes, and the incidence of specific nosocomial pathogens.
- To evaluate the acceptance and feasibility of implementing an ACP in hospital departments.
Summary:
- An interventional study in two hospital departments compared an ACP period with the previous year, analyzing antibiotic costs, mortality, readmissions, and incidence of MRSA and Clostridium difficile.
- The ACP involved 77 recommendations, with 85% acceptance, leading to stabilized antimicrobial use but increased oral and decreased parenteral administration.
- Significant findings include a 19.4% decrease in antimicrobial costs and a reduction in MRSA and Clostridium difficile incidence, with no adverse effects on mortality or readmission rates.
Impact:
- The implemented ACP, guided by infectious diseases specialists, was well-accepted by healthcare workers and led to reduced antibiotic expenditures through simplified therapy.
- The program did not negatively affect patient outcomes, suggesting its potential to decrease the incidence of certain nosocomial pathogens.
- Survey results indicated strong support among healthcare workers for extending the ACP to other hospital areas.