1023. Economic Impact of an Antimicrobial Stewardship Program Implementation in Three High-Complexity Hospitals in Colombia
Session: Poster Abstract Session: Antibiotic Stewardship: General Acute Care Implementation and Outcomes
Friday, October 28, 2016
Room: Poster Hall
Posters
  • Poster AMS final.pdf (462.9 kB)
  • Background: Antimicrobial stewardship programs (AMS) in hospitals seek to optimize antimicrobial prescribing in order to improve individual patient care as well as reduce hospital costs and slow the spread of antimicrobial resistance. In Colombia, few healthcare institutions have implemented well-designed AMS programs. The purpose of this study was to assess the economic impact of the implementation of an AMS program in high-complexity hospitals in Colombia.

    Methods: We conducted a quasi-experimental study between January 2007 and December 2014 in three high-complexity hospitals in two Colombian cities (Cali and Barranquilla). The study variables were evaluated in two periods: two years before and two years after the implementation of the AMS. The structure and development of the AMS program was determined for each hospital and initiated at different times within the study period. A modified index of AMS (ICATB1) which have maximum score of 20, was used. Micro-costing techniques were used to determine the consumption of hospital resources. Cost assignment was performed based on the reference costs of 2014. Antibiotic use was estimated based on the defined daily doses (DDD). Data was analyzed using descriptive and inferential statistics.

    Results: The study was implemented in medical-surgical intensive care units (ICUs) and general wards. All three hospitals had empirical antibiotic guidelines according to the local epidemiology and staff monitored prospectively the AMS program. The global ICATB1 score was 17 to 19.5 during the implementation. The antibiotic consumption in the ICUs decreased post-implementation with meropenem 20% (p=0.005), piperacillin/tazobactam 21% (p=0.003) and cefepime 6% (p=0.4). The cost of antibiotic consumptions had a 52.3% reduction per month, in average $33,540 USD pre-implementation vs $15,989 USD post-implementation (p<0.001). The cost of AMS program implementation was in average $4,305 USD per month.

    Conclusion: Our study outcomes confirm the importance and economic impact of implementing an AMS program in healthcare institutions. When instituting an AMS program, a hospital should tailor its choice of strategies to its needs and available resources. Similar programs in several other institutions in the country are underway.

    Cristhian Hernández-Gómez, BSc1, Christian Pallares, MD, MSc1,2, Kevin Escandón-Vargas, MD1, Sergio Reyes, MD1, Soraya Salcedo, MD, MSc3, Lorena Matta, MD, MSc4 and Maria Virginia Villegas, MD, MSc, FIDSA1, (1)Bacterial Resistance and Hospital Epidemiology, International Center for Medical Research and Training CIDEIM, Cali, Colombia, (2)Hospital Universitario Evaristo García, Cali, Colombia, (3)Clínica General del Norte, Barranquilla, Colombia, (4)Clínica Rafael Uribe Uribe, Cali, Colombia

    Disclosures:

    C. Hernández-Gómez, Merck Sharp & Dohme: Consultant , Consulting fee

    C. Pallares, Merck Sharp & Dohme: Consultant , Consulting fee

    K. Escandón-Vargas, None

    S. Reyes, None

    S. Salcedo, None

    L. Matta, None

    M. V. Villegas, Merck Sharp & Dohme: Consultant , Consulting fee and Research support

    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.