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.
Y. Pasikhova, None