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Institution-specific versus published in vitro antimicrobial susceptibility data in making formulary decisions
American Journal of Hospital Pharmacy
|January 1, 1987
Summary
Antimicrobial susceptibility testing of local pathogens is crucial. Comparing in vitro results with published data revealed significant discrepancies, highlighting the need for institutional testing before formulary inclusion.
Area of Science:
- Clinical Microbiology
- Pharmacology
- Infectious Diseases
Background:
- Published antimicrobial susceptibility data may not accurately reflect local pathogen resistance patterns.
- Hospital formulary decisions often rely on external susceptibility reports.
Purpose of the Study:
- To compare in vitro antimicrobial susceptibility testing results of local gram-negative pathogens with published data.
- To evaluate the utility of institutional susceptibility testing in guiding antimicrobial agent selection for hospital formularies.
Main Methods:
- Conducted Kirby-Bauer disk diffusion susceptibility tests on 549 gram-negative isolates from hospitalized patients against 17 antimicrobial agents.
- Compared institutional test results with published susceptibility data, analyzing discrepancies.
- Assigned a ranking to discordant results based on percentage difference.
Main Results:
- 34 of 77 drug-organism pairs showed over 10% difference from published susceptibility values.
- 26 instances indicated actual testing results were at least 10% lower than published data.
- Seven antimicrobial agents were removed from formulary consideration due to unexpectedly poor in vitro activity against local pathogens.
Conclusions:
- In vitro susceptibility testing of local pathogens provides a more reliable prediction of efficacy for new antimicrobial agents than relying solely on published data.
- Pharmacy and therapeutics committees should incorporate institutional pathogen susceptibility testing into the evaluation process for new antimicrobial agents proposed for formulary addition.