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Model predicts antimicrobial stewardship programs may reduce infection, costs in hemodialysis facilities
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A model on the implementation of an antimicrobial stewardship program in outpatient dialysis facilities predicted a substantial decrease seen in infection caused by multidrug-resistant organisms and Clostridium difficile, infection-related mortality and costs.
Researchers developed a decision analytic model on antimicrobial use on clinical and economic consequences of the implementation of a nationwide antimicrobial stewardship program in outpatient dialysis facilities. Main outcomes evaluated included total antimicrobial use, infections caused by multidrug-resistant organisms and C. difficile, infection-related mortality and total costs. All outpatient patients on hemodialysis in the United States were included in the analysis.
The incremental differences in clinical endpoints and cost outcomes were calculated based on the value of implementing antimicrobial stewardship programs, with the assumption there was a 20% decrease in unnecessary antimicrobial doses. Publicly available sources provided information on event probabilities, antimicrobial regimens and health care costs.
Results showed the implementation of antimicrobial stewardship programs on a national level was predicted to result in 2,182 fewer infections caused by multidrug-resistant organisms and C. difficile. This was a 4.8% decrease. The implementation of the program also predicted to result is 629 fewer infection-related deaths, a 4.6% decrease. There was a cost saving of $106,893,517 per year, a 5% decrease. Investigators noted the model was most sensitive to clinical outcomes compared with antimicrobial costs. – by Monica Jaramillo
Disclosures: The study was supported by the Agency of Healthcare Research and Quality (R18 HS021666 [EMCD]) and the National Institute of Allergy and Infectious Diseases (K24 AI119158 [EMCD]).
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D’Agata EMC, et al. Clin J Am Soc Nephrol.2018;doi:10.2215/CJN.12521117.
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