Successful Antimicrobial Stewardship Program at a Teaching Hospital

Background: Multidisciplinary antimicrobial utilization teams have been proposed as an instrument for improving antimicrobial use. Although rigorous clinical data in support of this strategy is lacking, the most effective means of improving antimicrobial stewardship will most likely involve a comprehensive program that incorporates multiple strategies and collaboration among various specialties within a given healthcare institution. Objective: To study antimicrobial use and to determine the impact of a multidisciplinary antimicrobial utilization team on antimicrobial use at a teaching hospital. Methods: A multidisciplinary antimicrobial utilization team for the development of a hospital-wide intervention program was formed to optimize the quality of antibiotic use in hospitals. Prospective, unit-based surveillance on antimicrobial use, from January 2009 to September 2009, took place. Four successive steps were developed during this period: baseline data collection, introduction of a prescription form, education, and prescribing control. The data are standardized by use of the defined daily dose (DDD) for each antimicrobial defined by the WHO and by calculating use per 1000 patient days. Results: Sustained reduction of drug consumption was shown during the study's period. Comparison between 1st and 3rd Quarter 2009, we observed a use's reduction of ampicillin group: 30.7%, antipseudomonal penicillins: 11%, antistaphylococcal penicillins: 73,7%, first-generation cephalosporins: 17%, fluoroquinolones: 37.8%, and vancomycin: 12.8%. Conclusions: The present study indicates that a systematic program performed by an multidisciplinary antimicrobial utilization team is an effective strategy for optimizing antibiotic prescribing. Multidisciplinary antimicrobial utilization team improved the quality of antimicrobial use and decrease cost without compromising patient outcome.