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Favorable Impact of a Multidisciplinary Antibiotic Management Program Conducted During 7 Years

Published online by Cambridge University Press:  02 January 2015

Philip Carling ,
Teresa Fung ,
Ann Killion ,
Norma Terrin  and
Michael Barza
Philip Carling*
Affiliation:
Infectious Diseases Section, Carney Hospital, Boston, Massachusetts Boston University School of Medicine, Boston, Massachusetts Tufts University School of Medicine, Boston, Massachusetts
Teresa Fung
Affiliation:
Infectious Diseases Section, Carney Hospital, Boston, Massachusetts
Ann Killion
Affiliation:
Infectious Diseases Section, Carney Hospital, Boston, Massachusetts
Norma Terrin
Affiliation:
Tufts University School of Medicine, Boston, Massachusetts
Michael Barza
Affiliation:
Infectious Diseases Section, Carney Hospital, Boston, Massachusetts Tufts University School of Medicine, Boston, Massachusetts
*
Infectious Diseases Section, Carney Hospital, 2100 Dorchester Avenue, Boston, MA 02124
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Abstract

Objective:

To evaluate the impact of an interventional multidisciplinary antibiotic management program on expenditures for antibiotics and on the incidence of nosocomial infections caused by Clostridium difficile and antibiotic-resistant pathogens during 7 years.

Design:

Prospective study with comparison with preintervention trends.

Setting:

University-affiliated teaching hospital.

Patients:

All adult inpatients.

Intervention:

A multidisciplinary antibiotic management program to minimize the inappropriate use of third-generation cephalosporins was implemented in 1991. Its impact was evaluated prospectively. The incidence of nosocomial C. difficile and resistant Enterobacteriaceae infections as well as the rate of vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) were compared with those of National Nosocomial Infections Surveillance System hospitals of similar size.

Results:

Following implementation of the program, there was a 22% decrease in the use of parenteral broad-spectrum antibiotics (P < .0001) despite a 15% increase in acuity of patient care during the following 7 years. Concomitantly, there was a significant (P= .002) decrease in nosocomial infections caused by C. difficile and a significant (P = .02) decrease in nosocomial infections caused by resistant Enterobacteriaceae. The program also appeared to have a favorable impact on VRE rates without a sustained impact on MRSA rates.

Conclusion:

These results suggest that an ongoing multidisciplinary antibiotic management program may have a sustained beneficial impact on both expenditures for antibiotics and the incidence of nosocomial infection by C. difficile and resistant bacterial pathogens.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 9 , September 2003 , pp. 699 - 706
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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