How 7 hospitals approach antibiotic stewardship

The Pew Charitable Trusts released a report Tuesday examining the successful antibiotic stewardship programs of 10 different healthcare facilities across the country.

Below are seven hospital and health systems whose antibiotic stewardship programs were examined in the report.

1. Williamson Medical Center (Franklin, Tenn.): WMC's stewardship program formally began in 2012. By tracking stewardship interventions, educating employees and utilizing other strategies, the antibiotic cost per single day of hospitalization for a patient at WMC decreased from $15.64 per day in 2012 and 2013 to $14.12 per day in 2014. C. diff cases per 10,000 days of patient hospitalization decreased from 26.3 in 2013 to 21.1 in 2014.

2. St. Tammany Parish Hospital (Covington, La.): STPH's ASP began in an effort to reduce surgical-site infections. Adherence to the ASP's recommendations resulted in a decrease in the occurrence of C. diff infections from 9.6 cases per 10,000 days in the third quarter of 2013 to 6.4 cases per 10,000 days of hospitalization by the end of 2014.

3. Blessing Hospital (Quincy, Ill.): Administrators at Blessing Hospital initiated an ASP after recognizing an increase in patterns of antibiotic resistance among patients. The ASP began with a three-month pilot study on the use of antibiotics in the hospital. The hospital estimates that the pilot study, which focused on four antibiotics and implementation of a therapy conversion protocol to facilitate a faster transition off of intravenous antibiotics, saved at least $6,000 per month.

4. Asante Health System (Medford, Ore.): AHS is a three-hospital health system with locations within 75 miles of one another in Medford, Grant's Pass and Ashland. To foster sustainability and expansion of its ASP, Asante is developing an outpatient parenteral antibiotic therapy service, which will be implemented across the entire health system. The service will allow patients to be discharged on intravenous antibiotic therapy, thereby shortening the length of hospitalization and providing significant cost savings.

5. University of California Davis Medical Center: Though UCDMC has had iterations of an ASP since 1986, the organization was first able to measure improved outcomes linked to stewardship through a pilot program launched in 2011. UCDMC was able to cut the rates of C. diff infections by 23 percent by adhering to antibiotic interventions initiated by their ASP.

6. Strong Memorial Hospital (Rochester, N.Y.): Strong Memorial Hospital has more than 700 licensed beds and is the academic medical center for the University of Rochester School of Medicine. Strong Memorial Hospital's ASP reported that antibiotic use per 1,000 days of patient hospitalization has remained consistently low since the implementation of the program.

7. University of Alabama at Birmingham Hospital: In 2005, in a stewardship move that predated the organization's official ASP, the hospital conducted an analysis that indicated an increase in the use of the antibiotic fluoroquinolone. The hospital implemented a restriction program for this specific antibiotic. After the restrictions, the hospital detected increased sensitivity in some gram-negative pathogens to ciprofloxacin. These results led to the formal creation of UABH's formal ASP in 2008.

More articles on antibiotic stewardship: 
IDSA, SHEA release new antibiotic stewardship guidelines: 4 things to know  
3 key elements of environmental disinfection improvement efforts  
Subway prioritizes antibiotic stewardship with new antibiotic-free meat 

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