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Tracking Antibiotic Use Reaps Big Hospital Cost Savings

MRSA bacteria (CDC)

Scanning electron micrograph image of MRSA bacteria (Janice Haney Carr, Centers for Disease Control and Prevention)

Analysis of a program to monitor unnecessary use of antibiotics shows the program saved one big-city hospital millions of dollars without compromising patient care. That’s the conclusion of a study done by researchers at University of Maryland Medical Center (UMMC) in Baltimore, where, the study was conducted, as well as colleagues from hospitals in Wilmington, Delaware, Denver, Colorado, and Portland, Oregon. The findings appear in the April 2012 issue of the journal Infection Control and Hospital Epidemiology.

Antimicrobial stewardship programs, as this type of initiative is called, help professionals who prescribe drugs know when antibiotics are needed and what the best treatment choices are for a particular patient. The UMMC program featured an antimicrobial monitoring team made up of an infectious diseases physician and a clinical pharmacist with infectious diseases training.

This team made daily rounds and provided real time monitoring of antimicrobial use with interventions and education when changes in treatment were recommended. The monitors led UMMC staff discussions about changes to antibiotics in the approved list of medications, and the development of related policies and guidelines.

The study evaluated the seven-year program and found UMMC able to eliminate $3 million from the hospital’s annual budget for antimicrobials by its third year. After seven years, the medical center had cut antibiotic spending per-patient day nearly in half. UMMC realized cost savings across hospital departments, including the cancer and trauma centers, surgical and medical intensive care units, and transplant service.

The study also found that savings from the program did not compromise the quality of patient care. The analysis found no increases in mortality, length of stay, or readmission to the hospital. “Our results clearly show that an antimicrobial stewardship program like the one at UMMC is safe, effective, and makes good financial sense,” says Harold Standiford, medical director for antimicrobial effectiveness at UMMC and the study’s lead author.

The paper published in the journal, however, includes a postscript with a less positive outcome.  UMMC terminated the program in 2008, in order to provide additional staff for infectious disease consultations throughout the hospital. Within two years, antimicrobial costs at UMMC increased by 32 percent to nearly $2 million. The medical center has since restarted a modified stewardship program including the use of a monitoring team.

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