New York Hospital Queens research demonstrates potential cost savings, improved outcomes, wtih Antibiotic Stewardship Programs

Research conducted by New York Hospital Queens (NYHQ) infectious disease experts has demonstrated that antibiotic stewardship programs, which promote the appropriate use of antibiotics in hospitals and other healthcare centers, have the potential to lead to reduced use of antibiotics, reduced adverse events, and significant savings. Their findings were presented on Sept. 6 at the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), an infectious diseases meeting of the American Society for Microbiology (ASM).

According to the U.S. Centers for Disease Control and Prevention (CDC), overprescribing and misprescribing antibiotics is contributing to the growing challenges posed by Clostridium difficile and antibiotic-resistant bacteria. In recognition of the urgent need to improve antibiotic use in hospitals and a growing body of evidence about the benefits of antibiotic stewardship programs, in 2013 the CDC recommended that all acute care hospitals implement Antibiotic Stewardship Programs.

"Our work emphasizes the rational approach to treating patients: choosing antibiotics at correct doses only when really needed, limiting side-effects, limiting the selection of super bugs, and limiting the risk of infection to new patients admitted to hospitals," said Nishant Prasad, M.D., attending physician, The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NYHQ, first author of the study.

Dr. Prasad and his colleagues tracked the rate of antibiotic-resistant infections, antibiotic use patterns, and antibiotic-related costs after the implementation of a hospital-wide antibiotic stewardship program at NYHQ. At least half of the more than 5,000 interventions made by the program in 2013 improved patient safety and led to more than $600,000 in estimated antibiotic-related savings. Interventions included adjusting which antibiotic was used, recommending the discontinuation of antibiotic use, and dose adjustments.

Additionally, they found the rate of antibiotic-resistant infections decreased including methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Acinetobacter baumannii, Klebsiella pneumoniae, and hospital-acquired Clostridium difficile- associated diarrhea.

"With our antibiotic stewardship program, we demonstrated decreased antibiotic use and a notable decrease in antibiotic-resistant infections, as well as increased antibiotic-related cost savings. We believe these findings show that limiting unnecessary antibiotics improves patient safety and streamlines use of limited healthcare dollars," said Dr. Prasad.

The abstract is titled, "Impact of Antibiotic Stewardship Program Interventions on Multi-drug Resistant Organism Resistance Rates and Hospital Costs." Sorana Segal-Maurer, M.D., director, The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NYHQ, served as senior author. Other NYHQ contributors were Nathan Warren, R.P.A.C., Anna Kula, R.P.A.C., Noriel Mariano, M.Sc., Carl Urban, Ph.D. and Deborah Figueroa, Pharm.D.

The authors declare no financial or other conflicts of interest.