235. Evaluation of both financial and ecological metrics associated with an antimicrobial management team (AMT) within a large community-teaching health system
Session: Poster Abstract Session: Antimicrobial Stewardship in Clinical Practice
Friday, October 21, 2011
Room: Poster Hall B1
  • IDSA_Poster_09_06_11.png (235.7 kB)
  • Background: 

    Analyze the effectiveness of an antimicrobial management team (AMT) program.

    Methods:  The AMT program began in early 2010 and was initiated at 650 bed hospital. It involves a team of pharmacists and an ID specialist. The AMT recommends and initiates patient-specific therapeutic interventions based upon patient medical record review including de-escalation of therapy, dose adjustment, IV-PO transition, therapeutic discontinuation and optimization, and other appropriate clinical involvement specifically related to infectious diseases diagnoses. 

    Results:  The total drug expenditure for anti-infectives has decreased since the implementation of the AMT. Pre vs post AMT implementation, the total antibiotic related length of stay, average days of antibiotic therapy per admission, and average cost of antibiotic therapy per admission were 6.3 vs 5.8 days , 5.1 vs 4.5 days, and $317.28 vs 301.26, respectively. Overall, there has been a 21% decrease in the antibiotic cost per adjusted discharge attributable to AMT efforts which correlate to a $1.34M decrease in anti-infective expenditures from the previous fiscal year. The acceptance of recommendation since the implementation of AMT has been 72%. There was $93,000 in cost avoidance documented in Sentri7 ® primarily attributable to successful transition to oral antibiotics or completion of IV antibiotics in the outpatient infusion center. There has been a decrease in 30-day infectious diseases related readmission rate from 9.2% to 8.5% since the start of the program. Comparing 2009 to 2010, we noticed improved sensitivity of gram negative organism and increase rate of methicillin sensitive staphylococcus aureus. In addition, overall antibiotic prescribing practices have improved.

    Conclusion:  Early financial and ecological data show a net benefit to implementation of an AMT and that the costs associated with staff and resources to continue this program are offset by the substantial cost savings and cost avoidance it can achieve.  In addition, the AMT has been successful in influencing prescribing practices even in areas outside of the Main hospital, which serves to greatly expand the benefits associated with maintaining this service.  

    Subject Category: J. Clinical practice issues

    Ali Hassoun, MD FACP1, Edward H. Eiland III, Pharm.D., MBA, BCPS (AQ-ID) 2, Jonathan Edwards, MS3 and Mickala Thompson, pharm D3, (1)alabama Infectious diseases center, Huntsville, AL, (2)pharmacy, Huntsville hopital, Huntsville, AL, (3)Huntsville hopital, Huntsville, AL


    A. Hassoun, None

    E. H. Eiland III, None

    J. Edwards, None

    M. Thompson, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.