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Application of the Intelligent High-Throughput Antimicrobial Sensitivity Testing/Phage Screening System and Lar Index of Antimicrobial Resistance
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Impact of a computerized integrated antibiotic authorization system.

Israel Potasman1, Gabriela Naftali, Moti Grupper

  • 1Department of Infectious Diseases, Bnai Zion Medical Center, affiliated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. israel.potasman@b-zion.org.il

The Israel Medical Association Journal : IMAJ
|September 8, 2012
PubMed
Summary

A new computerized antibiotic authorization system, supervised by infectious diseases (ID) specialists, significantly reduced hospital antibiotic expenditure by 17%. This system also helped curb unnecessary prescriptions, contributing to cost savings and potentially improving patient outcomes.

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Area of Science:

  • Infectious Diseases
  • Health Economics
  • Medical Informatics

Background:

  • Antibiotic overuse and abuse drive microbial resistance, necessitating hospital-based antimicrobial stewardship.
  • Real-time supervision by infectious diseases (ID) specialists is crucial for managing antibiotic use in hospitals.

Purpose of the Study:

  • To assess the financial impact of a novel computerized antibiotic authorization system on hospital pharmacy budgets.
  • To evaluate the effectiveness of ID specialist-led electronic antibiotic review in controlling expenditures.

Main Methods:

  • A comparative study was conducted in a 400-bed university hospital, analyzing data from one year before and one year after system implementation.
  • Physicians electronically submitted antibiotic requests, which ID specialists reviewed within hours, with feedback provided to wards and pharmacy.
  • The system focused on controlling 35 specific antibiotics, with Pareto analysis identifying key high-cost drugs.

Main Results:

  • The computerized system led to a 17% reduction in antibiotic expenditure, saving approximately $200,000 USD in the first year.
  • 20% of antibiotic requests were rejected, primarily due to improper indications (43% of rejections).
  • Mortality rates decreased from 4.0 to 3.8 per 1000 hospitalization days over the study period.

Conclusions:

  • Computerized antibiotic control, facilitated by infectious diseases specialists, is a viable and cost-effective strategy.
  • This approach effectively reduces unnecessary antibiotic prescriptions and contributes to antimicrobial stewardship.
  • The system demonstrates potential for significant pharmacy budget savings and may positively influence patient mortality.