A World Wide Web–Based Antimicrobial Stewardship Program Improves Efficiency, Communication, and User Satisfaction and Reduces Cost in a Tertiary Care Pediatric Medical Center

Agwu, Allison L.; Lee, Carlton K. K.; Jain, Sanjay; Murray, Kara L.; Topolski, Jason; Miller, Robert E.; Townsend, Timothy R.; Lehmann, Christoph U.

doi:10.1086/591133

Cited by 99 publications

(80 citation statements)

References 18 publications

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“…Antibacterial ASPs in pediatric centers worldwide have recently been reported (45)(46)(47). However, as in the adult population, the relative infrequency of antifungal use compared with the use of antibacterial drugs has led to the development of antifungal stewardship being less forthcoming.…”

Section: Discussionmentioning

confidence: 99%

Systemic Antifungal Prescribing in Neonates and Children: Outcomes from the Antibiotic Resistance and Prescribing in European Children (ARPEC) Study

Lestner

Versporten

Doerholt

et al. 2015

Antimicrob Agents Chemother

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The appropriate use of systemic antifungals is vital in the prevention and treatment of invasive fungal infection (IFI) in immunosuppressed children and neonates. This multicenter observational study describes the inpatient prescribing practice of antifungal drugs for children and neonates and identifies factors associated with prescribing variability. A single-day point prevalence study of antimicrobial use in hospitalized neonates and children was performed between October and December 2012. The data were entered through a study-specific Web-based portal using a standardized data entry protocol.

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Section: Discussionmentioning

confidence: 99%

Systemic Antifungal Prescribing in Neonates and Children: Outcomes from the Antibiotic Resistance and Prescribing in European Children (ARPEC) Study

Lestner

Versporten

Doerholt

et al. 2015

Antimicrob Agents Chemother

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“…Restriction of clindamycin 48 (or clindamycin, cefotaxime, and vancomycin 27 ) has been shown to control outbreaks of nosocomial C difficile-associated diarrhea and VRE, respectively. More recently, Internetbased antimicrobial restriction programs 49,50 and a computerized (electronic) approval system 51 have been demonstrated to reduce antibiotic use at tertiary hospitals. Some studies have reported increased antibiotic drug susceptibilities after implementation of institutional preauthorization policies, 45,46,51 and at least 1 reported a decreased incidence of ceftazidime-resistant Klebsiella species after instituting a preapproval policy for cephalosporins.…”

Section: Formulary Restriction and Preauthorizationmentioning

confidence: 99%

Antimicrobial stewardship for inpatient facilities

Ohl

Luther

2011

Journal of Hospital Medicine

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Antibiotic stewardship aims to improve patient care and reduce unwanted consequences of antimicrobial overuse or misuse, including lowered efficacy, emergence of antimicrobial resistance, development of secondary infections, adverse drug reactions, increased length of hospital stay, and additional healthcare costs. Recent guidelines make specific recommendations for the development of institutional programs to enhance antimicrobial stewardship. Optimally, such programs should be comprehensive, multidisciplinary, supported by hospital and medical staff leadership, and should employ evidence‐based strategies that best fit local needs and resources. An infectious diseases physician and clinical pharmacist with infectious diseases training are recommended as core members of the multidisciplinary team, although a hospitalist with interest (and perhaps additional training) in antimicrobial therapy may be able to fill the void. Program directors and core members should be compensated for their time. Principal proactive strategies—with evidence supporting their consideration—include prospective audits, with intervention and feedback, formulary restriction, and preauthorization. Other strategies include persistent one‐on‐one education, guidelines adapted to local needs, and informatics to support clinical decision making. Intervention goals are to prevent unnecessary antimicrobial starts, to streamline or de‐escalate therapy early in its course, and to convert from parenteral to oral therapy, optimize dosing, and ensure the appropriate length of therapy. Most community hospitals, if sufficiently resourced, should be able to implement a successful antimicrobial stewardship program. Evidence suggests that good antimicrobial stewardship can lead to less overall and inappropriate antimicrobial use, lower drug‐related costs, reductions in Clostridium difficile–associated disease, and, in some studies, less emergence of antimicrobial resistance. Journal of Hospital Medicine 2011;6:S4‐S15 ©2011 Society of Hospital Medicine.

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“…Ensuring that hospitalized patients receive the right antimicrobial, at the right dose, at the right time, and for the right duration has been shown to reduce mortality, 1 reduce the risks of Clostridium difficileassociated diarrhea, 2 shorten length of stay, 3 reduce overall antimicrobial resistance within the facility, 4 and save money. 5 Yet despite these benefits, antimicrobial stewardship programs and interventions are far from the norm in US hospitals. There are 2 important myths about antimicrobial stewardship that likely contribute substantially to the gap between the recognized benefits and implementation of stewardship interventions.…”

mentioning

confidence: 99%

Engaging hospitalists in antimicrobial stewardship: The CDC perspective

Srinivasan

2011

Journal of Hospital Medicine

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There has never been a more important time to promote efforts to improve the use of antibiotics in hospitals. The growing challenges of C. difficile infections and antimicrobial resistance can both be addressed, at least in part, through so called “antimicrobial stewardship” efforts. Data suggest that when the right antibiotics are prescribed at the right dose for the right durations patient outcomes are improved and healthcare dollars are saved. That improving antibiotic use is a win‐win‐win is not in question; what remains to be determined is how best to ensure that these efforts are implemented in all hospitals. I believe that hospitalists must play an important role in advancing antimicrobial stewardship. Journal of Hospital Medicine 2011;6:S31‐S33.

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A World Wide Web–Based Antimicrobial Stewardship Program Improves Efficiency, Communication, and User Satisfaction and Reduces Cost in a Tertiary Care Pediatric Medical Center

Cited by 99 publications

References 18 publications

Systemic Antifungal Prescribing in Neonates and Children: Outcomes from the Antibiotic Resistance and Prescribing in European Children (ARPEC) Study

Systemic Antifungal Prescribing in Neonates and Children: Outcomes from the Antibiotic Resistance and Prescribing in European Children (ARPEC) Study

Antimicrobial stewardship for inpatient facilities

Engaging hospitalists in antimicrobial stewardship: The CDC perspective

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