Study examines how to improve hospitalized patients' access to antimicrobials

Published in the Journal of the American Pharmacist's Association, University of Minnesota researchers found that establishing better mechanisms for information sharing and collaboration between healthcare institutions may help facilitate timely and effective acquisition of non-stocked antimicrobials.

The research team says inefficient processes can be a barrier to acquiring urgently needed antimicrobials, but improved and proactive information sharing among local hospitals may help reduce that barrier.

"Every hospitalized patient with a life-threatening infection should be treated appropriately and promptly. It is our duty to ensure patients receive this same standard of treatment regardless of whether the antimicrobial is 'in stock' or not. It's crucial to develop protocols, collaborate together, and improve care for those patients requiring an antimicrobial that is not readily accessible," said Christine Thomas, a recently graduated infectious diseases fellow with the University of Minnesota Medical School.

The study found that hospitals vary in their stocking practices and often decide which antimicrobials to stock based on their clinical utility, how frequently they are used and cost. When a non-stocked antimicrobial is needed, hospital pharmacies will most often buy it from their wholesale distributor. However, if the antimicrobial is needed more urgently than the distributor can accommodate, hospitals may instead ask to purchase the antimicrobial from another local institution.

"Many of us in infectious diseases are aware this practice exists, or have had first-hand experience trying to acquire an antimicrobial from a neighboring facility. Clearly we need a better system—or at a minimum, more data on how to acquire urgently needed therapies in an efficient and safe way," said Dr. Jonathan Alpern, assistant professor of medicine at the University of Minnesota Medical School.

The infectious diseases and antimicrobial stewardship pharmacists included in the study said the process could be improved by establishing better methods of information sharing between local hospitals, and proactively anticipating and planning for what non-stocked antimicrobials may be needed in the future.

Further research is recommended to better understand the burden of obtaining non-stocked antimicrobials on healthcare resources. Researchers say guidance should be developed to determine which antimicrobials should be stocked in hospital pharmacies and how to obtain antimicrobials that are not stocked, especially when it's urgently needed.