Monitoring antibiotic use cuts millions in wasteful spending, study finds

March 15, 2012, Society for Healthcare Epidemiology of America

Curbing unnecessary use of antibiotics is our best defense against the spread of drug-resistant infections. A new study suggests another benefit to antimicrobial stewardship: a potential cost savings of millions of dollars now wasted on therapies that don't help patients.

The research is published in the April issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America, in a special topic issue focused on antimicrobial stewardship. Antimicrobial stewardship programs and interventions help prescribers know when antibiotics are needed and what the best treatment choices are for a particular patient.

According to the study, which evaluated a seven-year antimicrobial stewardship program at University of Maryland Medical Center (UMMC), the program eliminated $3 million from the hospital's annual budget for by its third year. After seven years, it had cut antibiotic spending per-patient day nearly in half. Cost savings were evident across hospital departments, including the cancer center, , surgical and medical intensive care units and transplant service.

Importantly, these savings did not compromise quality of patient care. The study found no increases in mortality, length of stay, or to the hospital.

Despite its success, however, the program was terminated in 2008 in favor of providing more consults. The consequences of that decision were immediate. Antimicrobial costs increased by 32 percent—nearly $2 million—within two years after the program was terminated according to the research.

"Our results clearly show that an antimicrobial stewardship program like the one at UMMC is safe, effective, and makes good financial sense," said Harold Standiford, MD, medical director for antimicrobial effectiveness at UMMC and the study's lead author.

The central component of the UMMC program was an antimicrobial monitoring team (AMT) that included an infectious diseases physician and a clinical pharmacist with infectious diseases training. The AMT made daily rounds and provided real time monitoring of antimicrobial use with active intervention and education when changes in treatment were recommended. The team also provided leadership in discussions about changes to antibiotics on the formulary and the development of relative policies and guidelines.

When the program was terminated, the AMT was disbanded in favor of additional personnel who provided infectious diseases consults throughout the hospital including in areas caring for highly specialized patients. It was believed that these additional personnel, though decentralized, would provide appropriate stewardship and render the AMT redundant. That decision proved costly, however, and in light of this study's findings the medical center has restarted a modified stewardship program including an AMT.

"Our research shows that investing in stewardship not only helps preserve our dwindling antibiotic tools, it can also help to eliminate wasteful healthcare spending," Dr. Standiford said. "We believe it's an important lesson to keep in mind when considering the allocation of resources to stewardship programs."

Explore further: Drug-resistant infections: A new epidemic, and what you can do to help

More information: Harold C. Standiford, Shannon Chan, Megan Tripoli, Elizabeth Weekes, Graeme N Forrest, "Antimicrobial Stewardship at a Large Tertiary Care Academic Medical Center: Cost Analysis Before, During, and After a 7-Year Program." Infection Control and Hospital Epidemiology 33:4 (Special Topic Issue: Antimicrobial Stewardship, April 2012).

Related Stories

Drug-resistant infections: A new epidemic, and what you can do to help

November 10, 2011
(Medical Xpress)—Are you aware that colds, flu, most sore throats and bronchitis are caused by viruses? Did you know that antibiotics do not help fight viruses and that using them for viral infections only decreases their ...

Fighting drug-resistant 'super-bugs': UCLA expert offers protection tips

May 11, 2011
The new "super-bug" CRKP, known officially as carbapenem-resistant Klebsiella pneumoniae, is just the latest in a series of emerging drug-resistant strains of bacteria that pose a serious threat to human health. CRKP ...

Lifesaving antibiotics face doubtful future

April 7, 2011
To head off a health care disaster, the Infectious Diseases Society of America (IDSA) has developed a plan to combat deadly antibiotic-resistant "super bugs" and is rolling out the multi-pronged plan today, on World Health ...

Recommended for you

Onions could hold key to fighting antibiotic resistance

January 22, 2018
A type of onion could help the fight against antibiotic resistance in cases of tuberculosis, a UCL and Birkbeck-led study suggests.

New long-acting approach for malaria therapy developed

January 22, 2018
A new study, published in Nature Communications, conducted by the University of Liverpool and the Johns Hopkins University School of Medicine highlights a new 'long acting' medicine for the prevention of malaria.

Virus shown to be likely cause of mystery polio-like illness

January 22, 2018
A major review by UNSW researchers has identified strong evidence that a virus called Enterovirus D68 is the cause of a mystery polio-like illness that has paralysed children in the US, Canada and Europe.

Study ends debate over role of steroids in treating septic shock

January 19, 2018
The results from the largest ever study of septic shock could improve treatment for critically ill patients and save health systems worldwide hundreds of millions of dollars each year.

New approach could help curtail hospitalizations due to influenza infection

January 18, 2018
More than 700,000 Americans were hospitalized due to illnesses associated with the seasonal flu during the 2014-15 flu season, according to federal estimates. A radical new approach to vaccine development at UCLA may help ...

Flu may be spread just by breathing, new study shows; coughing and sneezing not required

January 18, 2018
It is easier to spread the influenza virus (flu) than previously thought, according to a new University of Maryland-led study released today. People commonly believe that they can catch the flu by exposure to droplets from ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

A_Paradox
not rated yet Mar 15, 2012
I wonder what really was the point of disbanding the antimicrobial monitoring team when they did. It sounded like something which 'wasn't busted' so was it just gormless bureaucratic politics and somebody trying to prove their worth by nobbling an easy target?

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.