This article is more than 5 years old. Information may no longer be current.
Antibiotic stewardship common in VA hospitals
Click Here to Manage Email Alerts
Recent findings published in Infection Control and Hospital Epidemiology showed that many Veterans Affairs facilities promoted appropriate antibiotic use and practiced coordinated antibiotic stewardship in 2012, before the implementation of stewardship efforts nationwide.
“This study was designed to take a snapshot of antimicrobial stewardship activities within the VA health care system in 2012, soon after the establishment of the VA Antimicrobial Stewardship Task Force, in which infectious diseases (ID) pharmacists and physicians began developing policies and educational tools to promote antimicrobial stewardship across the VA,” Ann F. Chou, PhD, associate professor at the University of Oklahoma Health Sciences Center, an affiliate of the VA Greater Los Angeles Healthcare System, told Infectious Disease News.
Ann F. Chou
About 30% to 50% of all inpatient antibiotic use is inappropriate, according to Chou and colleagues. In addition, a meta-analysis of clinical trials across different types of health care facilities between 1980 and 2009 showed that antimicrobial stewardship programs (ASPs) have reduced 34% to 43% of antibiotic prescriptions. Only a few studies, however, have actually reported a decrease of resistance or adverse events due to these programs, they said.
To describe ASPs and antibiotic prescription practices, the researchers analyzed an online survey administered in 2012 to all 130 VA facilities with inpatient services. Afterward, the researchers determined the association between each facility characteristic and inpatient antibiotic use.
They found that 9% of facilities approved an ASP business plan, 22% had established a formal ASP policy, 42% planned to develop an ASP plan and 38% had antibiotic stewardship teams. Of these teams, 69% included at least one clinical pharmacist with formal ID training. According to the researchers, 92% of facilities reported formulary restrictions to limit the use of specific antimicrobial agents, 75% maintained stop orders for antibiotic duration, 74% had written clinical pathways for specific conditions, and 94% of facilities had developed yearly antibiograms.
Results also showed that decreased antibiotic use was associated with the frequency of systematic patient-level reviews of antibiotic use (P = .01), using at least one full-time ID physician (P = .03), maintaining an ID fellowship program (P = .003), having a clinical pharmacist with formal ID training (P = .006), and having a policy to address antibiotic use against C. difficile infection (P = .01), while increased use was associated with stop orders for antibiotic duration (P = .03).
Facilities that rely on stop orders may need to reassess this process to ensure appropriate default duration, the researchers wrote.
According to Chou, the researchers are refining their study to adjust for confounding factors, but the findings “demonstrate the value of implementing antimicrobial stewardship.” – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts