1021. Universal Implementation of Antimicrobial Stewardship Programs Leads to Reduction in Antibiotic Use and Cost Savings: Pilot Results from a Large U.S. Health System 
Session: Poster Abstract Session: Antibiotic Stewardship: General Acute Care Implementation and Outcomes
Friday, October 28, 2016
Room: Poster Hall
  • IDSA-Poster-UnivImplementation-2016.pdf (247.4 kB)
  • Background: Antimicrobial stewardship (AS) plays a critical role in curbing the development of multidrug resistant organisms (MDROs). A system approach fosters accountability and encourages standardization at the hospital level. We describe the impact of establishing AS programs at the system and hospital levels on antibiotic use and cost.

    Methods: Each hospital developed physician-pharmacist co-led AS teams to ensure compliance with evidence based antimicrobial use, culture orders and standardized disease management process. Evidence-based indications for use were developed for Aztreonam, Ceftaroline, Daptomycin, Linezolid, Tigecycline and Ertapenem. Utilization over time by defined daily dose/ 1000 patient days (DDD/1000 pt. days) were shared with each facility monthly to identify successes, opportunities and develop plan of action. In addition, we directly engaged opportunity hospitals through phone calls and site visits.


    The actual patient days for FY’15 (12 months) and FY’16 YTD (9 months) were 3,656,268 and 2,678,512, respectively. For 85 hospitals, there was a drop in systemic antibiotic use from 941.8 (FY15) to 853.4 (FY16 YTD) DDD/ 1000 patient-days (9.4% reduction, p<0.001), and $2.4 million savings (annualized). There were significant reductions in the use of Aztreonam, Ceftaroline, Daptomycin, Ertapenem, Linezolid and Tigecycline (Table).

    Conclusion: A system-wide antimicrobial stewardship effort engaging hospitals with clear indications for use is associated with the reduction of inappropriate antibiotic use and cost.

    Roy Guharoy, PharmD, MBA1,2, Mohamad Fakih, MD, MPH, FIDSA3, Jeffrey Seggerman, MBA4, Florian Daragjati, PharmD, BCPS5, Clariciea Groves, MS4, Karen Smethers, Pharm.D.4, Danielle Sebastian, PharmD4, Dan Leffler, MS4 and Ann Hendrich, RN, PhD6, (1)Medicine, University of Massachusetts Medical School, Worcester, MA, (2)Care Excellence, Ascension Health, St. Louis, MO, (3)Ascension Center of Excellence for Antimicrobial Stewardship and Infection Prevention, St Louis, MO, (4)Ascension Health, St Louis, MO, (5)Ascension Health, Saint Louis, MO, (6)Care Excellence, Ascension Health, St Louis, MO


    R. Guharoy, None

    M. Fakih, None

    J. Seggerman, None

    F. Daragjati, None

    C. Groves, None

    K. Smethers, None

    D. Sebastian, None

    D. Leffler, None

    A. Hendrich, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.