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Practices to Improve Antimicrobial Use at 47 US Hospitals the Status of the 1997 SHEA/IDSA Position Paper Recommendations

Published online by Cambridge University Press:  02 January 2015

Rachel M. Lawton ,
Scott K. Fridkin ,
Robert P. Gaynes ,
John E. McGowan Jr  and
Intensive Care Antimicrobial Resistance Epidemiology (ICARE) Hospitals
Rachel M. Lawton*
Affiliation:
Hospital Infections Program, Rollins School of Public Health, Emory University, Atlanta, Georgia
Scott K. Fridkin
Affiliation:
Hospital Infections Program, Rollins School of Public Health, Emory University, Atlanta, Georgia
Robert P. Gaynes
Affiliation:
Hospital Infections Program, Rollins School of Public Health, Emory University, Atlanta, Georgia
John E. McGowan Jr
Affiliation:
National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, and the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
*
Hospital Infections Program, MS A-35, CDC, 1600 Clifton Rd, Atlanta, GA30333
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Abstract

Objective.

To determine the status of programs to improve antimicrobial prescribing at select US hospitals.

Design:

Cross-sectional survey.

Participants and Setting:

Pharmacy and infection control staff at all 47 hospitals participating in phase 3 of Project Intensive Care Antimicrobial Resistance Epidemiology.

Results:

All 47 hospitals had some programs to improve antimicrobial use, but the practices reported varied considerably. All used a formulary, and 43 (91%) used it in conjunction with at least one of the other three antimicrobial-use policies evaluated: stop orders, restriction, and criteria-based clinical practice guidelines (CPGs). CPGs were reported most commonly (70%), followed by stop orders (60%) and restriction policies (40%). Although consultation with an infectious disease physician (70%) or pharmacist (66%) was commonly used to influence initial antimicrobial choice, few (40%) reported a system to measure compliance with these consultations.

Conclusions:

In most hospitals surveyed, practices to improve antimicrobial use, although present, were inadequate based on recommendations in a Society for Healthcare Epidemiology of America and Infectious Disease Society of America joint position paper. There is room to improve antimicrobial-use stewardship at US hospitals.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 21 , Issue 4 , April 2000 , pp. 256 - 259
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2000

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