1424. Antimicrobial Stewardship at a NCI-designated Comprehensive Cancer Center in Southeastern United States: A Two Year Review
Session: Poster Abstract Session: Antimicrobial Stewardship: Interventions
Saturday, October 10, 2015
Room: Poster Hall
  • 2015 IDSA Poster for SMART at San Diego post AB YP AB RQ YP AB.pdf (930.8 kB)
  • Background: Since the first antibacterial agents were introduced in the 1930s-40s, antimicrobial use has pervaded all aspect of our society.  This widespread use has created resistant organisms. As a result, antimicrobial resistance has emerged as a significant global public health threat. One solution has been the establishment of antimicrobial stewardship, which aims to maximize clinical outcomes while minimizing antimicrobial use. There have been many documented cases of successful stewardship programs across various tertiary and academic institutions but few reports at major cancer treatment institution. In this paper, we report a stewardship program at one of the top NCI designated site in the Southeastern United States.

    Methods: Moffitt Cancer Center started its antimicrobial stewardship program in November 2012. From then until 2014, we collected utilization data on various drugs on both our restricted and non-restricted formulary. The restricted drugs included ertapenem, meropenem, imipenem, daptomycin, linezolid, micafungin. Non-restricted medications included vancomycin, cefepime and piperacillin-tazobactam. We also evaluated the impact of the program as it relates to cost avoidance and antimicrobial resistance. Susceptibility patterns for the following organisms were evaluated:  E. coli, Klebsiella pneumoniae, Stenotrophomonas maltophilia, Pseudomonas aeruginosa, Enterobacter cloacae.

    Results: Meropenem use was reduced by 50% from 2012 to 2014 without any increase in utilization of other carbapenems. We saw slightly more than 50% reduction in the use of Daptomycin and Linezolid over the time.  Our E. coli susceptibility to ciprofloxacin decreased by 10% but we saw a 3% increased in Pseudomonas susceptibility to Cefepime. Similar to other institutions across the nation, our Stenotrophomonas susceptibility to trimethoprim/sulfa dropped by 16%. During this time frame, the program resulted in cost avoidance of over 1.7 million dollars.

    Conclusion: We report a successful implementation of antibiotic stewardship program in a heavily immunocompromised patient population. Data assessing patient outcomes is needed to fully evaluate the safety and efficacy of an antimicrobial stewardship program in this setting. We hope to encourage more NCI sites to adopt stewardship programs in an era where MDRO are prevalent.

    Minh Ho, DO, Infectious Diseases and International Medicine, University of South Florida, Tampa, FL, Aliyah Baluch, MD, MSc, FACP, Division of Infectious Diseases, Moffitt Cancer Center, Tampa, FL and Yanina Pasikhova, Pharm.D., BCPS, Pharmacy, Moffitt Cancer Center, Tampa, FL


    M. Ho, None

    A. Baluch, None

    Y. Pasikhova, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.