Successful Implementation of an Antimicrobial Stewardship Program at an Academic Medical Center

Area of Science:

• Infectious Diseases
• Healthcare Management
• Pharmacology

Background:

• Regulatory bodies like the Joint Commission emphasize antimicrobial use and infection prevention.
• Centers for Medicare and Medicaid Services and Centers for Disease Control highlight the need for antimicrobial stewardship programs.
• Healthcare facilities require ongoing development of antimicrobial stewardship programs.

Purpose of the Study:

• To evaluate antimicrobial use at a healthcare institution.
• To develop a successful antimicrobial stewardship program based on established guidelines.
• To identify areas for improvement in antimicrobial prescribing practices.

Main Methods:

• Utilized 2007 Infectious Diseases Society of America and Society for Healthcare Epidemiology guidelines.
• Conducted three baseline evaluations including retrospective chart reviews.
• Assessed formulary restrictions, dosing optimization, and intravenous to oral conversion of antimicrobials.

Main Results:

• 40% of levofloxacin orders lacked clinical justification for nonformulary use.
• 49% of meropenem orders did not adhere to the dose optimization program.
• Opportunities identified for converting fluconazole and voriconazole to oral therapy.

Conclusions:

• Baseline evaluations confirmed the necessity of an antimicrobial stewardship program.
• The article details the process of assessing, planning, implementing, and evaluating such a program.
• Optimizing antimicrobial use is essential for effective infection prevention and patient care.