964. The Status of Antimicrobial Stewardship in a Sample of 25 Acute Care Hospitals
Session: Poster Abstract Session: Stewardship: Epidemiology of Antibiotic Use
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
  • 964_IDWPOSTER.pdf (184.2 kB)
  • Background:  Hospitals are attempting to address the increase in antimicrobial resistance, the increasing costs of antimicrobials, and the paucity of new antimicrobials entering the marketplace.  We assessed the status of antimicrobial stewardship (AS) efforts in a small sample of hospitals.

    Methods:  A web-based survey was created based on the recommendations of the 2007 IDSA/SHEA Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship.

    Results:  There were 44 hospitals surveyed, and 25 responses (56.8%).  Fifty-six percent indicated they had the support of hospital administration and 40% also felt supported by their medical staff leadership.

    The top three activities for AS efforts included dose optimization (70.8%), parenteral -to- oral (IV to PO) conversion (66.7%), and evidence-based clinical pathways (50%).  Formulary restriction (41.7%), prescriber education (41.7%), de-escalation therapy (41.7%), and prospective audit with feedback (37.5%) were also observed.  Twenty-one percent reported that AS efforts currently did not include any of the listed elements.

    Seventy-six percent of respondents reported use of electronic medical records, 48% reported use of computer-based surveillance, 44% have computerized physician order entry, and 24% have clinical decision support.  The majority of respondents reported clinical microbiology laboratory support in the form of antibiograms (79.2%), and patient-specific susceptibility data (75%).

    Conclusion:  Most respondents are making good strides in the development of antimicrobial stewardship within their facilities, based on the SHEA/IDSA Guidelines

    Less resource-intense supplementary elements such as dose optimization and IV-to-PO conversion are occurring with greater frequency.  The two core proactive antimicrobial stewardship strategies recommended in the IDSA/SHEA Guidelines, formulary restriction and prospective audit, are only in place in a little over a third of the facilities.  There is a relatively high prevalence of microbiology lab supports such as antibiograms and patient-specific susceptibility data.  Further topics for investigation should include examination of the effectiveness of various antimicrobial stewardship strategies in subpopulations within the acute care setting.

    Gayle Allenback, MS1,2, David Woodard, MSc, CLS, CIC1 and Patricia Cruz, PhD2, (1)Infection Control & Prevention, Valley Health System, Las Vegas, NV, (2)School of Community Health Sciences, University of Nevada, Las Vegas, Las Vegas, NV


    G. Allenback, None

    D. Woodard, None

    P. Cruz, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.