AI Article Synopsis
- The study assessed a multidisciplinary antibiotic management program's effects on antibiotic spending and hospital-acquired infections over 7 years.
- Implemented in 1991, the program aimed to reduce inappropriate use of broad-spectrum antibiotics, specifically third-generation cephalosporins, among adult inpatients at a university-affiliated hospital.
- Results showed a 22% decrease in broad-spectrum antibiotic use and significant reductions in nosocomial infections from Clostridium difficile and resistant Enterobacteriaceae, indicating the program's positive impact on both cost and infection rates.
Article 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.
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| http://dx.doi.org/10.1086/502278 | DOI Listing |
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