Antimicrobial surveillance in a VAMC teaching hospital--resulting cost avoidance

The economic impact of an antimicrobial surveillance service is presented. The antimicrobial surveillance service operates as a component of antimicrobial utilization review and serves as a means of identifying and reporting patterns of antimicrobial usage for the hospital. A record of all antimicrobial agent orders is maintained by the pharmacy service. Concurrent antimicrobial utilization review is conducted on specific agents using previously approved criteria. All cases of antimicrobial use failing to meet established criteria receive immediate intervention. From September, 1983 to June, 1985, a total of 229 cases of antimicrobial use received clinical pharmacy intervention. The cost avoidance appreciated from the selection of a more cost-effective regimen was $65,381.60. Additionally, extensive educational efforts directed to cefazolin q8h vs. cefazolin q6h administration resulted in a substantial reduction in cefazolin expenditures. Indiscriminate/inappropriate use of antimicrobial agents delivers a tremendous economic burden to the health care system. Utilizing antimicrobial surveillance as a component of antimicrobial utilization review serves as a means for identifying and reporting patterns of antimicrobial usage for the medical center and has a positive economic impact as illustrated.