Effectiveness of a Pharmacist Driven Antibiotic Stewardship Program at Two Critical Access Hospitals Using a Remote Infectious Diseases Pharmacist
Methods: The ID specialist remotely reviewed patients receiving antibiotics at each CAH daily. The ID specialist provided recommendations to the CAH pharmacist, who then made the recommendations to the provider. For the first CAH, recommendation type and outcome were documented by the CAH pharmacists. For the second CAH, the ID specialist documented number of patients reviewed, number of recommendations made to the CAH pharmacist, number of recommendations communicated to the provider, and recommendation type and outcome.
Results: During the first year at hospital one, the ASP made 247 recommendations with an acceptance rate of 88%. Total antibiotic use decreased 4.3% and cost decreased 3.4%. During the first 6 months at hospital two, 424 patient reviews were completed by the ID specialist resulting in 85 recommendations to the CAH pharmacist. Of those recommendations communicated to the provider (N=75, 88%), there was an 87% acceptance rate. During the first 5 months, antibiotic use decreased 12.2% and cost increased 6.2%.
Conclusion: The ASPs at these two CAHs are unique in that they are pharmacist-driven and utilize an ID pharmacist and ID pharmacy resident as the ID specialist. This study demonstrates that using a remote ID pharmacist and ID pharmacy resident is a potential model for healthcare systems to provide ASP services to multiple institutions that would otherwise not have the resources to implement an ASP individually.
S. Leslie, None
J. Holt, None