Antimicrobial Stewardship in Community Hospitals

Buckel, Whitney R.; Veillette, John J.; Vento, Todd J.; Stenehjem, Edward

doi:10.1016/j.mcna.2018.05.005

Cited by 37 publications

(35 citation statements)

References 49 publications

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“…Community hospitals often have less access to ID expertise and are less likely to have robust ASPs than academic medical centers [ 37 ]. Shively and colleagues sought to describe the practical implementation and assess the effectiveness of a telehealth-based ASP (TeleASP) in 2 community hospitals using the expertise of a large health network in Pennsylvania [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

A Baker’s Dozen of Top Antimicrobial Stewardship Intervention Publications in 2019

Stover

Chahine

Cluck

et al. 2020

Open Forum Infectious Diseases

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Staying current on literature related to antimicrobial stewardship can be challenging given the ever-increasing number of published articles. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related peer-reviewed literature that detailed an actionable intervention for 2019. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the actionable intervention used by antimicrobial stewardship programs to provide key stewardship literature for teaching and training as well as to identify potential intervention opportunities within one’s institution

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Section: Resultsmentioning

confidence: 99%

A Baker’s Dozen of Top Antimicrobial Stewardship Intervention Publications in 2019

Stover

Chahine

Cluck

et al. 2020

Open Forum Infectious Diseases

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Section: Discussionmentioning

confidence: 99%

“…One particular strength of the current study is its completion in a community hospital setting, which have historically been underrepresented in published literature on antimicrobial stewardship interventions. 19 ASPs in community hospitals have unique challenges as compared with those at large academic medical centers. 20 The current study demonstrates that the use of prescriber peer comparison reports to reduce FQ use in a community hospital setting of various bed sizes is feasible and can be effective at altering prescribing habits.…”

Section: Discussionmentioning

confidence: 99%

Effect of prescriber peer comparison reports on fluoroquinolone use across a 16‐facility community hospital system

Allen

Dunn²,

Bush³

2019

J Am Coll Clin Pharm

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Introduction Antimicrobial stewardship programs (ASPs) continuously strive to optimize antibiotic use, while minimizing antibiotic‐associated adverse events. Among potential targets for antibiotic use reduction, fluoroquinolones (FQs) are an attractive drug class for ASPs due to their wide spectrum of activity, known adverse event profile, and availability of less toxic therapeutic options. The use of peer comparison on antibiotic use by ASPs has been described but is limited primarily to the outpatient setting. Objectives To assess the impact of peer comparison using prescriber‐specific reports on FQ use and hospital‐acquired Clostridioides difficile rates across a 16‐facility community hospital system. Methods In January 2017, we began providing quarterly facility‐specific peer comparison reports to high‐volume antibiotic prescribers in three different medical specialties across our health‐system: Internal Medicine/Hospitalists/Family Medicine, Intensivists/Pulmonologists, and infectious diseases (ID). We completed a quasi‐experimental study designed to assess aggregated hospital data, evaluating FQ days of therapy/1000 patient days (DOT/1000 PD) in the intervention period (January‐December 2017), and compared with the baseline period (January‐December 2016). Additional outcomes that were evaluated include total antibiotic consumption (DOT/1000 PD), total percentage of antibiotics attributable to FQs, and cases of hospital‐acquired C. difficile/10000 PD (HA‐CD). Results Compared with the baseline period, FQ use decreased by 29% (baseline—83.9 DOT/1000 PD; intervention—58.5 DOT/1000 PD; P < 0.001). The overall percentage of antibiotics that were attributable to FQs also decreased in the intervention period (baseline—15.4%; intervention—11.3%; P < 0.001). During the intervention period, there were no significant increases in other key antibiotic classes, including antipseudomonal beta‐lactams and third‐generation cephalosporins. The rate of HA‐CD decreased by 20% in the intervention period compared with baseline. Conclusion In a large community hospital system, the use of peer comparison reports based on prescriber specialty reduced FQ use, and may potentially reduce adverse events associated with FQ use.

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“…44,54 Small community hospitals (<200 beds) represent 72% of US nonfederal hospitals, but only 31% of hospitals with <50 beds and 26% of critical-access hospitals (<25 beds) have an ASP featuring all 7 CDC core elements. [55][56][57] Despite these substantial barriers, successes have been demonstrated in the community setting by optimizing available resources. 54,[57][58][59][60] Even among US News and World Reports (USNWR) highestranking hospitals, a recently published 2016 survey reported that fewer than half of institutions (48%) have a dedicated ASP budget.…”

Section: Surveys Describing Stewardship Staffing and Financial Needs mentioning

confidence: 99%

Antimicrobial stewardship staffing: How much is enough?

Greene

Nesbitt

Nelson

2019

Infect. Control Hosp. Epidemiol.

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Antimicrobial stewardship improves patient care and reduces antimicrobial resistance, inappropriate use, and adverse outcomes. Despite high-profile mandates for antimicrobial stewardship programs across the healthcare continuum, descriptive data, and recommendations for dedicated resources, including appropriate physician, pharmacist, data analytics, and administrative staffing support, are not robust. This review summarizes the current literature on antimicrobial stewardship staffing and calls for the development of minimum staffing recommendations.

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Antimicrobial Stewardship in Community Hospitals

Cited by 37 publications

References 49 publications

A Baker’s Dozen of Top Antimicrobial Stewardship Intervention Publications in 2019

A Baker’s Dozen of Top Antimicrobial Stewardship Intervention Publications in 2019

Effect of prescriber peer comparison reports on fluoroquinolone use across a 16‐facility community hospital system

Antimicrobial stewardship staffing: How much is enough?

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