492. Impact of Education on Drug Utilization- One Year Experience in Two Community Hospitals with a Mandatory Methicillin Resistant Staphylococcus aureus (MRSA) Surveillance Program
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: New Jersey law requires hospitals to implement a MRSA surveillance program (SP). Previously, we reported that anti-MRSA antibiotic costs rose despite stable MRSA infection rates, suggesting prescribing for colonization vs. infection. Clinical education programs were conducted and the impact of these programs on antibiotic use was assessed.
Methods: Two community hospitals participated; St. Mary’s Hospital (SM) and East Orange General (EOGH). Assessment and education period was Jan. to Dec. 2008. Data included total number screened, percent positive via nasal swab, and MRSA infection rates based on microbiology cultures. Vancomycin (VAN), daptomycin, linezolid, and quinupristin/dalfopristin use was measured using total defined daily dose per 1000 patient days (DDD/1000) and cost per patient day ($/PD) for the corresponding time period. Data from 2008 was compared to 2007 pre-SP and 3 months post-SP values.
Results: At SM, 1053 patients were screened and 13% (n=135) were MRSA positive.
Drug utilization in 2008 increased 42% (90.9) from pre-SP (63.9) and 15% from post-SP (78.9). Costs in 2008 increased 11%($2.34) from pre-SP ($2.11) but decreased 30% from post-SP ($3.34). At EOGH, 6510 patients were screened and 12% (n=755) were MRSA positive. Drug utilization increased 31% (82.3) from pre-SP (62.8) but decreased 6% (86.8) from post-SP. Total drug costs ($3.48) increased 104% from pre-SP ($1.71) but only 4% from post-SP ($3.36). VAN comprised more than 75% of total drug utilization for all periods. MRSA infection rates were unchanged in all reported periods.
Conclusion: In these 2 hospitals, extensive education had a varied impact on anti-MRSA drug use and did not lower costs and utilization numbers to pre-surveillance levels. Multiple approaches are needed to help hospitals and clinicians with cost effective management of mandatory surveillance programs.
Bhavna Desai, MT, St Mary's Hospital, Passaic, NJ, Diana Finkel, DO, St Mary's Hospital, Fair Lawn, NJ, Kevin McDonough, BS, PharmD , MPA, Aldyth Stanford, RN, East Orange General Hospital and  D. Finkel,
Roche Role(s): Consultant, Received: Consulting Fee.
B. Desai, None..
A. Stanford, None..
K. McDonough, None.