Pharmacist Reporting of Antimicrobial Interventions Post Antimicrobial Stewardship Implementation

Background: An Antimicrobial Stewardship Program (ASP) is a team-based multidisciplinary approach to enhancing utilization of antimicrobials. According to the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA), an appropriate ASP is one whose primary goal is to “optimize clinical outcomes while minimizing unintended consequences of antimicrobial use, including toxicity, the selection of pathogenic organisms and the emergence of resistance.” The role of the ASP clinical pharmacist includes optimizing antibiotic regimens through: prospective audits of antimicrobial usage, drug information, de-escalation of therapy, dose optimization, and intravenous to oral conversions. In January of 2011, a multidisciplinary ASP was established at Interim Louisiana Hospital (ILH), a center of excellence teaching institution that provides medical care to indigent and uninsured patients in the New Orleans area. Objectives: The purpose of this study is to evaluate the impact of clinical pharmacy team on the frequency and categories of antimicrobial interventions. A secondary outcome will be to determine the cost-savings benefit of the ASP team and stabilization of microbial resistance patterns. Methods: Antimicrobial interventions that were reported in the year of 2010, prior to ASP implementation, and 2011, post ASP implementation, will be obtained from Pharmacy OneSource® Quantifi®. Pharmacy OneSource® Quantifi® is a hospital based software that records interventions per pharmacist per day. The frequency of antimicrobial interventions per drug class will be compared using descriptive statistics and a Fishers Exact analysis using SPSS19. The cost savings impact of ASP implementation will be determined by evaluating pharmacy-purchasing data. Cost data will be compared using hospital wide and patient day utilization of antibiotics. Finally, microbial resistance patterns comparing the 2010 and 2011 antibiograms will be analyzed using ANOVA analysis to determine if the ASP initiative has contributed to stabilization of resistance patterns. Results: Pending Conclusion: Pending