GLOWACKI RC, SCHWARTZ DN, ITOKAZU GS, WISNIEWSKI M, KIESZKOWSKI P, WEINSTEIN RA; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. O-390.

Cook County Hospital/ University of Illinois at Chicago, Chicago, IL

BACKGROUND: Antibiotic (AB) combinations with redundant antimicrobial spectra (RAS) are a potentially remediable source of AB overuse. In a previous point prevalence study, 31% of patients on 2 or more AB had antibiotic combinations (AC) with RAS (ACRAS). We prospectively measured the incidence of ACRAS and attempted to simplify therapy when it was identified. METHODS: A table of formulary AB to define AC with possible RAS was applied to adult inpatient medication profiles. An Infectious Diseases pharmacist reviewed charts of patients with possible ACRAS for AB indications and alerted the pharmacy and/or prescribing physician when the AC was deemed redundant. Patient demographics, types and sources of errors and duration of antibiotic overlap were abstracted. Redundant drug costs were determined and potential savings from interventions calculated. AB regimens of 1189 patients on 2 or more AB were reviewed on 23 days (mean 52 patients/day) over 5 weeks; 192 cases of potential ACRAS were identified (16%; range 9-31% per observation day). RESULTS: AC were inappropriate in 137/192 (71%) cases (11.5% of patients on 2 or more AB). Interventions were accepted in 100/104 cases (96%). Physician prescribing errors were found in 74 (54%) cases; most involved redundant gram-positive or anaerobic coverage. The cost of these redundant drugs was $2800, and the intervention saved up to $4500. Lapses in the hospital drug ordering and distribution system caused errors in 74 cases (54%) at a potential drug cost of $6300. The pharmacist time for patient review and intervention cost $2400. CONCLUSION: Pharmacist review and correction of ACRAS offers a cost-effective means of reducing inpatient AB use and risk of side effects to patients.

Publication Types:

• Meeting Abstracts

Keywords:

• Adult
• Anti-Bacterial Agents
• Anti-Infective Agents
• Costs and Cost Analysis
• Drug Costs
• Humans
• Longitudinal Studies
• Pharmaceutical Preparations
• Pharmacists
• Prescriptions, Drug
• Prospective Studies
• economics
• methods
• utilization

Other ID:

• GWAIDS0030595

UI: 102270232

From Meeting Abstracts