232. Results of a Nationwide Survey on Stewardship Practices in Acute Care Hospitals
Session: Poster Abstract Session: Antimicrobial Stewardship in Clinical Practice
Friday, October 21, 2011
Room: Poster Hall B1
  • 232_KatieLusardi.pdf (73.0 kB)
  • Background: Interest in antimicrobial stewardship programs (ASP) has increased following the publication of the 2007 IDSA/SHEA guidelines. The frequency of programs in existence that fully align with these guidelines is not well characterized.   The purpose of this study was to evaluate ASPs in acute care hospitals and identify variables that predict the presence of a program that meets guideline definitions.

    Methods: U.S. based pharmacists were surveyed via email in February and March 2011. Data collected included stewardship personnel, practice site, elements of stewardship programs (core and supplemental strategies), and barriers.  Programs were divided into two categories; fully compliant and partially guideline compliant. Programs categorized as “fully compliant” had a dedicated ID physician and pharmacist and had implemented at least one core strategy from the guidelines. Programs categorized “partially compliant” did not have dedicated ID personnel and/or did not implement any core strategies.

    Results: Three hundred and sixteen responses were received. Forty two responses were excluded due to duplicates, incomplete, or non-USA data. Of the remaining 274 responses, 68.7% (n=187) did not meet the definition of fully guideline compliant. The most frequently cited barrier to implementing a full stewardship program was lack of funding and personnel (45%, n= 122). Fifty-five percent (n=42/76) of academic medical centers and 22.7% (n=44/194) of community hospitals were fully guideline compliant (p<0.0001). Programs with full adherence to the guidelines have been in existence longer than programs who met the partial definition (4.6+ 4.8 years vs 2.5+3.6 years, p=0.018). ASPs that were aligned with guidelines were more likely to identify their program as “very effective” (50% vs 42%, p=0.022).

    Conclusion: The majority of hospitals in the US do not have antimicrobial stewardship programs that fully align with recent guidelines, primarily due to lack of funding and personnel. Programs that have successfully implemented the guidelines are more likely to exist in academic medical centers, have existed longer and have a favorable impression of their effectiveness.

    Subject Category: J. Clinical practice issues

    Katherine T. Lusardi, PharmD1,2, Kristi Kuper, PharmD2, Elizabeth A. Coyle, PharmD1 and Kevin W. Garey, PharmD, M.S.1, (1)Clinical Sciences and Administration, University of Houston College of Pharmacy, Houston, TX, (2)Cardinal Health Pharmacy Solutions, Houston, TX


    K. T. Lusardi, None

    K. Kuper, Cardinal Health Pharmacy Solutions: Employee, Salary

    E. A. Coyle, None

    K. W. Garey, T2 Biosystems: Grant Investigator, Research grant

    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.