Impact of an Antimicrobial Stewardship Program on Unnecessary Double Anaerobic Coverage Prescription

Area of Science:

• Infectious Diseases
• Antimicrobial Stewardship
• Clinical Pharmacy

Background:

• Co-administration of multiple antimicrobials with anti-anaerobic activity is generally not recommended.
• Unnecessary double anaerobic coverage (DAC) contributes to antimicrobial resistance and increased healthcare costs.
• An intervention was designed to decrease the prescription of unnecessary DAC.

Purpose of the Study:

• To evaluate the effectiveness of a multidisciplinary antimicrobial stewardship program in reducing unnecessary double anaerobic coverage (DAC).
• To assess the impact of combined educational and audit-feedback strategies on DAC prescription rates.

Main Methods:

• An intervention involving intranet-based education, prospective audits, and feedback was implemented.
• Collaboration between a pharmacist and an infectious diseases physician facilitated the intervention.
• Monthly data on unnecessary DAC prescriptions were collected and analyzed over a 1-year study period (6 months pre-intervention, 6 months intervention).

Main Results:

• The average monthly number of patients with unnecessary DAC prescriptions decreased by 73.9% (from 26.8 to 7.0).
• The proportion of patients receiving unnecessary DAC among all DAC prescriptions fell by 67.8% (from 42.3% to 13.6%).
• Statistical analysis confirmed a significant reduction in unnecessary DAC prescriptions (P = 0.005 for monthly number, P < 0.001 for proportion).

Conclusions:

• A multidisciplinary antimicrobial stewardship program effectively reduced unnecessary double anaerobic coverage (DAC) prescriptions.
• Combined methods of education and prospective audit-feedback are successful in optimizing antimicrobial use.
• The intervention demonstrates a successful strategy for improving antibiotic prescribing practices in a hospital setting.