Anti-MRSA Agents Use in the Era of Active antimicrobial Stewardship Programs: Is there a Difference Based on Hospital Size
Background: The goals of Antimicrobial stewardship programs (ASPs) are to reduce antimicrobial resistance, optimize therapy and patient outcomes. We assessed the impact of antimicrobial stewardship on the utilization of anti-MRSA agents based on hospital size.
Methods: We evaluated the use of ceftaroline , vancomycin, clindamycin, daptomycin, linezolid and tigecycline (defined daily dose (DDD)/1000 patient days) at 85 facilities based on stratified annual patient days (≤25,000; 25,001 to 50,000; 50,001 to 100,000; and >100,000). We assessed the impact of our recently implemented antimicrobial stewardship program (established criteria for use, local adoption, and direct engagement of outlier hospitals) by comparing fiscal years FY15 (12 months) and FY16 YTD (9 months) inpatient data.
Results: The actual patient days for FY15 and FY16 YTD were 3,656,268 and 2,678,512, respectively. Individual facility Anti-MRSA agent use showed a trend of reduction systemwide (n=85 hospitals) from 171.2 to 145.7 (p=0.090) (Table). Antimicrobial stewardship programs had a significant impact on reduction of DDD/1000 patient days at for facilities ≤ 25,000 patient-days/ year. Vancomycin use increased for 25,001-100,000 patient days/year facilities. For both fiscal years combined, ceftaroline , vancomycin, clindamycin, and daptomycin were used more in facilities with ≤25,000 than >25,000 patient-days/ year (p<0.001).
Conclusion: Establishing antibiotic stewardship programs had a significant impact on small facilities utilization of anti-MRSA agents. In some situations, the reduction in some anti-MRSA agents led to an increase in vancomycin use.
C. Groves, None
F. Daragjati, None
D. Leffler, None
D. Sebastian, None
M. Fakih, None
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