Novel expansion of a well-established antimicrobial stewardship program: Enhancing program efficiency and reach

Area of Science:

• Infectious Diseases
• Healthcare Management
• Clinical Pharmacy

Background:

• Antimicrobial resistance necessitates robust antimicrobial stewardship programs (ASPs).
• Prospective-audit-with-feedback (PAF) is a key ASP strategy.
• Efficiently expanding PAF reviews is crucial for comprehensive antibiotic oversight.

Purpose of the Study:

• To assess the efficiency and impact of a novel ASP PAF review process.
• To evaluate the use of Cerner Multi-Patient Task List (MPTL) for expanding PAF reviews.
• To determine changes in antibiotic utilization and intervention characteristics.

Main Methods:

• Retrospective cohort study at a pediatric academic medical center.
• Compared pre- and post-implementation periods of an expanded ASP PAF review process using MPTL.
• Analyzed daily reviews, monthly interventions, time for reviews, and antibiotic days of therapy (DOT).

Main Results:

• Significant increase in average daily ASP reviews (9 to 14) and monthly interventions (34 to 52).
• Overall antibiotic DOT per 1,000 patient days decreased significantly (457.9 to 427.9).
• Utilization of select narrow-spectrum antibiotics decreased; nonantibiotic interventions increased.

Conclusions:

• MPTL facilitated efficient expansion of the ASP PAF review process.
• The expanded ASP led to a significant decrease in overall antibiotic utilization.
• Enhanced documentation through MPTL improved tracking of ASP impact.