How one Colorado hospital cut antibiotic use by nearly 11 percent

Children's Hospital Colorado has cut inpatient's antibiotic use by 10.9 percent through a unique antimicrobial "handshake stewardship" program.  

According to CDC, antibiotic resistance causes more than 23,000 deaths and about $20 billion in indirect health care costs annually in the United States.

Children's Hospital Colorado's antimicrobial stewardship program, which the hospital refers to as the "handshake stewardship," is defined by three main features:

  • A lack of restrictions and preauthorization requirements that are commonly found in antimicrobial programs;
  • Daily reviews of every inpatient antibiotic prescription—including dosages, medication type, and infection type—by a pharmacist and physician; and
  • Daily pharmacist and physician team rounds on inpatient floors to monitor antibiotic use and offer in-person advice to every unit using antibiotics.

Program Results

To assess the program, researchers from the hospital retrospectively measured antimicrobial use per unit and hospital-wide during the pre-implementation, planning, and post-implementation phases of the stewardship program. The researchers reviewed data on all antibiotics prescribed to inpatients at the hospital between October 2010 and September 2014. The findings were published last year in the Pediatric Infectious Disease Journal.

According to Healthcare Finance News, the researchers found that the program produced significant results over the four-year study period. For instance, the researchers found that overall antimicrobial use decreased by 10.9 percent. Further, the researchers found a:

  • 16.4 percent decrease in antiviral use among inpatients at the hospital;
  • 12.1 percent decrease in antifungal use among inpatients; and
  • 10.3 percent decrease in antibacterial use.

The researchers concluded that "the handshake stewardship approach is an effective strategy for an antimicrobial stewardship program, as demonstrated by the widespread and significant decrease in antimicrobial use after implementation."

Woman killed by superbug resistant to all US-approved antibiotics

Comments

Sarah Parker, a pediatric infectious disease physician who led the study and serves as the medical director of the hospital's stewardship program, said "The risks associated with antibiotics require that we find an effective way to limit their use."

She added, "This type of stewardship … helps ensure the appropriate use of antibiotics—that is, that they are only used when needed, and that they are given at the right dosage for the right duration of time," which "ultimately … leads to better patient outcomes" (Lagasse, Healthcare Finance News, 4/17; Vaidya, Becker's Hospital Review, 4/19;  Parker et al., The Pediatric Infectious Disease Journal, October 2016).

Video: The state of hospital antibiotic stewardship programs

The majority of hospitals are starting to invest in antibiotic stewardship programs, but our recent survey shows there's still plenty of work to be done.

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