Computer-assisted antimicrobial surveillance in a community teaching hospital

Area of Science:

• Health Economics
• Infectious Diseases
• Clinical Pharmacy

Background:

• Rising antimicrobial drug costs and inappropriate use necessitated a surveillance program.
• A 369-bed community teaching hospital implemented a new antimicrobial surveillance program in January 1994.

Purpose of the Study:

• To describe a computer-assisted, pharmacy-managed antimicrobial surveillance service.
• To evaluate the impact of this service on cost, clinical outcomes, and physician acceptance of recommendations.

Main Methods:

• Established a computer interface between pharmacy and microbiology databases for rapid access to results.
• Pharmacists reviewed patient data and recommended therapy changes to physicians.
• Monitored antimicrobial therapy for 1384 patients from January to July 1994.

Main Results:

• Interventions were recommended for 348 patients (25%), with 83% accepted by physicians.
• Infections resolved in 97% of patients whose recommendations were accepted.
• Cost avoidance exceeded $32,000, justifying the pharmacist position.

Conclusions:

• A computer-assisted, pharmacy-managed antimicrobial surveillance service effectively controls costs.
• The service contributes to favorable clinical outcomes in patients receiving antimicrobial therapy.