Infect Chemother.  2015 Jun;47(2):111-116. 10.3947/ic.2015.47.2.111.

Impact of an Antimicrobial Stewardship Program on Unnecessary Double Anaerobic Coverage Prescription

• Song YJ
• Kim M
• Huh S
• Lee J
• Lee E
• Song KH
• Kim ES
• Kim HB

• KMID: 2068995
• DOI: http://doi.org/10.3947/ic.2015.47.2.111

Abstract

BACKGROUND
Co-administration of two or more antimicrobials with anti-anaerobic activity is not recommended except in certain circumstances. We therefore conducted an intervention to reduce unnecessary double anaerobic coverage (DAC) prescription.
MATERIALS AND METHODS
The intervention consisted of education using an institutional intranet and prospective audits and feedback provided through collaboration between a pharmacist and an infectious diseases physician in Seoul National University Bundang Hospital, a tertiary hospital in Seongnam, Republic of Korea, in 2013. The study period was 1 year which contained 6 months of pre-intervention period and 6 months of intervention period. To estimate the overall effect of the intervention, we compared the monthly number of patients receiving unnecessary DAC for more than 3 days and the proportion of patients receiving unnecessary DAC for more than 3 days among all patients receiving DAC.
RESULTS
The average monthly number of patients receiving unnecessary DAC for more than 3 days after screening decreased by 73.9% in the intervention period from 26.8 to 7.0. Wilcoxon rank sum test revealed there was a significant statistical difference in the monthly number of patients receiving unnecessary DAC for more than 3 days (P = 0.005). The proportion of patients receiving unnecessary DAC for more than 3 days after screening among all patients identified as receiving necessary or unnecessary DAC also decreased by 67.8% in the intervention period from 42.3% to 13.6% (P < 0.001).
CONCLUSION
The multidisciplinary antimicrobial stewardship program with combined methods reduced unnecessary DAC prescription successfully.

Keyword

Antimicrobial stewardship program; Inappropriate prescribing; Anaerobic bacteria

MeSH Terms

Bacteria, Anaerobic
Communicable Diseases
Computer Communication Networks
Cooperative Behavior
Education
Gyeonggi-do
Humans
Inappropriate Prescribing
Mass Screening
Pharmacists
Prescriptions*
Republic of Korea
Seoul
Tertiary Care Centers

Figure

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  Figure 1 Flow diagram of the study and intervention. DAC, double anaerobic coverage.

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  Figure 2 Patients receiving necessary or unnecessary DAC. DAC, double anaerobic coverage; CDI, Clostridium difficile infection. aExceptional circumstances of necessary DAC other than CDI. bThe number of patients receiving unnecessary DAC at screening.

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  Figure 3 Patients receiving unnecessary DAC at screening. DAC, double anaerobic coverage. aThe number of patients receiving unnecessary DAC at screening. bThe proportion of patients receiving unnecessary DAC at screening among all patients receiving DAC.

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  Figure 4 Patients receiving unnecessary DAC for more than 3 days. DAC, double anaerobic coverage. aThe number of patients receiving unnecessary DAC at screening. bThe proportion of patients receiving unnecessary DAC for more than 3 days among all patients receiving DAC. cThe proportion of patients receiving unnecessary DAC for more than 3 days among patients receiving unnecessary DAC at screening.

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