Cost-effectiveness of prospective and continuous parenteral antibiotic control: Experience at the Palo Alto Veterans Affairs Medical Center from 1987 to 1989

Abstract

Antibiotic control policies can be developed to ensure quality care and can be designed to select for cost-effective agents. Prospective and continuous monitoring of antibiotic usage by the IDS resulted in a significant and sustained reduction in antibiotic costs without detrimental effect on the length of therapy or deaths.

Impact of the Hospital Pharmacy Initiative for promoting prudent use of antibiotics in hospitals in England

“…Once susceptibility reports are available, the pharmacist can match these against an empirical prescription and intervene if necessary, [3][4][5][6] but it has been argued that the role of the pharmacist extends beyond checking sensitivity results. Pharmacists with a strong background in microbiology are increasingly recognized as an integral part of the infection management team and can offer specialist advice on optimal antimicrobial therapy, as well as providing education, audit and feedback to prescribers, and writing evidence-based guidelines for antimicrobial prescribing.…”

Impact of a restrictive antimicrobial policy on the process and timing of antimicrobial administration

“…This approval process may take the form of submitting written justification forms and/or direct telephone/fax requests to an Infectious Disease specialist, Clinical Pharmacist, or other surrogate prior to release of the antibiotic from the pharmacy. While these approval processes and other strategies have been shown to reduce the development of resistance, 7,8 improve outcomes, 8 and provide education and revision of antimicrobial choice that may be more appropriate for the patient and suspected infection, 9 they have the potential to delay the administration of the necessary antimicrobial by adding additional steps to the sequence of ordering, obtaining, and administering the medication. While it is certainly desirable to control the indiscriminant use of these medications, delays in antimicrobial administration may, in turn, worsen outcomes, thus counteracting the beneficial effects of control policies.…”

An Integrated Approach to Antimicrobial Stewardship in the Hospital Setting

“…In this scenario, the clinical pharmacist conducts a concurrent review of all orders for restricted antimicrobial agents. Based on the pharmacist's review, recommendations are provided to the prescriber (52,53). Disagreement between the clinical pharmacist and the prescriber automatically result in default to an in-…”