Program Schedule

218
Changes in Antimicrobial Prescribing Patterns Following Implementation of The Oregon Antimicrobial Stewardship Collaborative (OASC)

Session: Poster Abstract Session: Antibiotic Stewardship
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • ASP poster 2014 - IDWeek 9 25 14 final.pdf (723.0 kB)
  • BACKGROUND:  We implemented OASC as a statewide model to develop and support antimicrobial stewardship programs (ASP) for hospitals.

    METHODS:  Thirteen hospitals committed to participate in OASC, receiving educational and program support for ASP creation or expansion.  The participating hospitals agreed to provide both baseline and prospective antimicrobial utilization data, in DDD (defined daily dose) and DOT (days of therapy) format.  We computed DDD/DOT using General Estimating Equations (GEE) modeled with a log-linear Poisson distribution. 

    RESULTS: Data for analysis was available for 8 adult hospitals:  2 small hospitals (< 50 beds), 4 medium hospitals (50-199 beds), and 2 large hospitals (≥ 200 beds).  Data were divided into the following periods for analysis:  baseline (January 2012 – October 2012), preparatory (November 2012 – March 2013), and post-intervention (April 2013 – November 2013). 

    Prior to the start of the observation period, the collaborative hospitals were prescribing on average 547.3 DDD/1,000 patient days and 572.5 DOT/1,000 patient days.   The post-intervention DDD trend decreased by 4.3% compared to the baseline trend (p=0.001), and 3.7% compared to the preparatory phase; during the post intervention period, DDD continued to decrease by 3.0% per month (Figure 1.).  The DOT trend decreased non-significantly compared to the baseline trend.

    Figure 1.     

                                  

    CONCLUSION:  In the context of a statewide ASP collaborative, we saw decreasing trends in antimicrobial prescribing when comparing post-intervention DDD trends to baseline and preparatory trends.  Further, the DDD continued to decrease in the post-intervention period, suggesting a sustained impact following implementation of the collaborative.

    Lynne Strasfeld, MD, Division of Infectious Disease, Oregon Health and Science University, Portland, OR, Melissa Parkerton, MA, Oregon Patient Safety Commission, Portland, OR, Robert F. Arao, MPH, Public Health Division, Oregon Health Authority, Portland, OR, Zintars G. Beldavs, MS, Acute & Communicable Disease Prevention, Oregon Health Authority, Portland, OR, Katherine Ellingson, PhD, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, Jwan Mohammadi, Infectious Diseases, Portland VA Medical Center, Portland, OR, Ann Thomas, MD, MPH, Oregon Public Health Division, Portland, OR and Graeme Forrest, MBBS, Division of Infectious Disease, Veterans Affairs Medical Center, Portland, OR

    Disclosures:

    L. Strasfeld, None

    M. Parkerton, None

    R. F. Arao, None

    Z. G. Beldavs, None

    K. Ellingson, None

    J. Mohammadi, None

    A. Thomas, None

    G. Forrest, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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