Adherence to antimicrobial agent recommendations and utilization during drug shortages

Area of Science:

• Pharmacology
• Infectious Diseases
• Healthcare Management

Background:

• Antimicrobial shortages are frequent, impacting drug utilization patterns.
• Understanding the effects of shortages on antimicrobial prescribing is crucial for patient care and stewardship.

Purpose of the Study:

• To characterize antimicrobial agent use during shortages.
• To assess antimicrobial utilization post-shortage resolution.
• To examine the use of alternative antimicrobials during shortage periods.

Main Methods:

• Retrospective chart review of 266 inpatients receiving restricted antimicrobials.
• Analysis of days of therapy per 1,000 patient days for shortage and alternative agents.
• Evaluation of adherence to restriction criteria and impact of interventions like visual cues.

Main Results:

• 57% of antimicrobial use adhered to restriction criteria; meropenem, ampicillin/sulbactam, and piperacillin/tazobactam showed highest adherence.
• Nonadherent use was associated with shorter therapy duration and specific indications (e.g., sepsis rule out, UTI).
• Visual cues increased adherence (99% vs. 94%); alternative agent use significantly increased during shortages.

Conclusions:

• Restriction strategies reduced shortage antimicrobial utilization but have room for improvement.
• Identifying alternative agents and implementing visual cues are effective strategies to enhance antimicrobial stewardship during shortages.