Antimicrobial Stewardship in a Community Hospital: Attacking the More Difficult Problems

Published in Hospital Pharmacy

Background: Antibiotic stewardship has been proposed as an important way to reduce or prevent
antibiotic resistance. In 2001, a community hospital implemented an antimicrobial management
program. It was successful in reducing antimicrobial utilization and expenditure. In 2011, with the
implementation of a data-mining tool, the program was expanded and its focus transitioned from
control of antimicrobial use to guiding judicious antimicrobial prescribing.

Objective: To test the hypothesis that adding a data-mining tool to an existing antimicrobial stewardship
program will further increase appropriate use of antimicrobials.

Results: During 2012, 2,003 antimicrobial interventions were made with a 90% acceptance rate.
Targeted broad-spectrum antimicrobial use decreased by 15% in 2012 compared to 2010, which
represented cost savings of $1,621,730. There were no statistically signifi cant changes in antimicrobial
resistance, and no adverse patient outcomes were noted.

Conclusions: The addition of a data-mining tool to an antimicrobial stewardship program can
further decrease inappropriate use of antimicrobials, provide a greater reduction in overall antimicrobial
use, and provide increased cost savings without negatively affecting patient outcomes.

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