Effects of a Remote Antimicrobial Stewardship Program on Antimicrobial Use in a Regional Hospital System

Area of Science:

• Health Services Research
• Infectious Diseases
• Quality Improvement

Background:

• Antimicrobial stewardship programs (ASPs) are crucial for combating antimicrobial resistance but are often resource-limited in smaller or rural hospitals.
• Developing scalable and resource-efficient ASP models is essential for widespread implementation.
• Remote delivery models offer a potential solution for extending ASP services to underserved facilities.

Purpose of the Study:

• To implement and evaluate a pharmacist-led remote ASP targeting antimicrobial use in a hospital system.
• To assess the impact of the remote ASP on overall, facility-specific, and targeted antimicrobial consumption.
• To analyze the efficiency of pharmacist interventions and the utilization of infectious disease (ID) physician support.

Main Methods:

• A quality improvement study comparing antimicrobial use (DOT/1000 PD) six months before and after remote ASP implementation.
• System-wide and facility-specific antimicrobial use data were analyzed, focusing on targeted agents.
• Pharmacist interventions, acceptance rates, and requests for ID physician assistance were systematically tracked.

Main Results:

• System-wide antimicrobial use decreased by 4.6% post-implementation.
• Significant reductions were observed in the use of vancomycin, piperacillin/tazobactam, and fluoroquinolones.
• Pharmacist interventions had a high acceptance rate (91%), with minimal need for direct ID physician involvement (38 requests, 6 interventions).

Conclusions:

• A pharmacist-led remote ASP effectively reduced antimicrobial use across a hospital system, including targeted agents.
• This model is a viable strategy for resource-limited settings, demonstrating efficiency and high intervention acceptance.
• Remote ASPs can optimize antimicrobial use while minimizing the additional workload for infectious disease specialists.