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Antimicrobial stewardship at a large tertiary care academic medical center: cost analysis before, during, and after a 7-year program.
MedLine Citation:
PMID:  22418628     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background. An antimicrobial stewardship program was fully implemented at the University of Maryland Medical Center in July 2001 (beginning of fiscal year [FY] 2002). Essential to the program was an antimicrobial monitoring team (AMT) consisting of an infectious diseases-trained clinical pharmacist and a part-time infectious diseases physician that provided real-time monitoring of antimicrobial orders and active intervention and education when necessary. The program continued for 7 years and was terminated in order to use the resources to increase infectious diseases consults throughout the medical center as an alternative mode of stewardship. Design. A descriptive cost analysis before, during, and after the program. Patients/setting. A large tertiary care teaching medical center. Methods. Monitoring the utilization (dispensing) costs of the antimicrobial agents quarterly for each FY. Results. The utilization costs decreased from $44,181 per 1,000 patient-days at baseline prior to the full implementation of the program (FY 2001) to $23,933 (a 45.8% decrease) by the end of the program (FY 2008). There was a reduction of approximately $3 million within the first 3 years, much of which was the result of a decrease in the use of antifungal agents in the cancer center. After the program was discontinued at the end of FY 2008, antimicrobial costs increased from $23,933 to $31,653 per 1,000 patient-days, a 32.3% increase within 2 years that is equivalent to a $2 million increase for the medical center, mostly in the antibacterial category. Conclusions. The antimicrobial stewardship program, using an antimicrobial monitoring team, was extremely cost effective over this 7-year period.
Authors:
Harold C Standiford; Shannon Chan; Megan Tripoli; Elizabeth Weekes; Graeme N Forrest
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America     Volume:  33     ISSN:  1559-6834     ISO Abbreviation:  Infect Control Hosp Epidemiol     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804099     Medline TA:  Infect Control Hosp Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  338-45     Citation Subset:  IM; N    
Affiliation:
University of Maryland Medical Center, Baltimore, Maryland.
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