Adventure Administrator 9/19/21 Adventure Administrator 9/19/21

Rural Antibiotic Stewardship Program Gets Big-City Boost Via Telemedicine

Distance need not be a barrier in optimizing antibiotic stewardship, according to a poster about a novel telemedicine program presented at the 2018 ASHP Midyear Clinical Meeting.

Adventure Administrator 9/18/21 Adventure Administrator 9/18/21

A World Wide Web-based antimicrobial stewardship program improves efficiency, communication, and user satisfaction and reduces cost in a tertiary care pediatric medical center.

Electronic Monitoring – Implementation of a web-based program to provide automated clinical decision support, faciliate approval and real-time communication with prescribers related to antibiotics.

Adventure Administrator 9/17/21 Adventure Administrator 9/17/21

Enforcing a policy for restricting antimicrobial drug use

Restriction – Eight IV antibiotics (amikacin, aztreonam, ceftazidime, ciprofloxacin, fluconazole, imipenem-cilastatin, ofloxacin, and ticarcillin-clavulanate, (aztreonam was added to list two months into intervention) previously needed approval, but enforcement of restrictions lax. All staff informed that ID approval needed for dispensement and that pharmacists needed to be informed in writing or by telephone. Enhanced enforcement included issuing warnings to pharmacists if restricted antibiotics dispensed without ID approval.

Adventure Administrator 9/16/21 Adventure Administrator 9/16/21

Impact of a computerized clinical decision support system on reducing inappropriate antimicrobial use: A randomized controlled trial

Electronic Monitoring – randomized controlled trial of active monitoring by antimicrobial management team of all restricted antibiotic orders with a computer system compared to a group without the computer system to alert for inadequate antimicrobial therapy.

Adventure Administrator 9/15/21 Adventure Administrator 9/15/21

Antibiotic tele-stewardship program reduces antibiotic use, improving patient outcomes

Distance need not be a barrier in optimizing antibiotic stewardship, according to a poster about a novel telemedicine program presented at the 2018 ASHP Midyear Clinical Meeting.

Adventure Administrator 9/14/21 Adventure Administrator 9/14/21

Antibiotic Combinations with Redundant Antimicrobial Spectra: Clinical Epidemiology and Pilot Intervention of Computer-Assisted Surveillance

Streamlining – Patients on two or more antibiotics identified by computer. After records review for redundant combinations, pharmacist would contact clinician to determine clinical indication and make recommendations for streamlining when appropriate.

Adventure Administrator 9/13/21 Adventure Administrator 9/13/21

A randomized, prospective study measuring outcomes after antibiotic therapy intervention by a multidisciplinary consult team.

Patients with known resistant infections randomized to an intervention consult vs. usual care. Interventional consult done by multidisciplinary team and made recommendations for appropriate therapies while also weighing economic factors of medication.

Adventure Administrator 9/12/21 Adventure Administrator 9/12/21

Antimicrobial Stewardship (ASP) in Rural and Critical Access Hospitals (CAHs) Using TeleStewardship® Services

Distance need not be a barrier in optimizing antibiotic stewardship, according to a poster about a novel telemedicine program presented at the 2018 ASHP Midyear Clinical Meeting.

Adventure Administrator 9/11/21 Adventure Administrator 9/11/21

Antibiotic optimization. An evaluation of patient safety and economic outcomes

Multidisciplinary – Three month randomized controlled trial of patients receiving parenteral antibiotics for three or more consecutive days. Intervention group received suggestion for antibiotics from ID and pharmacist. The control did not.

Adventure Administrator 9/10/21 Adventure Administrator 9/10/21

TeleStewardship services in combination with rapid blood pathogen detection increased antimicrobial stewardship interventions and improved compliance with Joint Commission Standards

Distance need not be a barrier in optimizing antibiotic stewardship, according to a poster about a novel telemedicine program presented at the 2018 ASHP Midyear Clinical Meeting.

Adventure Administrator 9/9/21 Adventure Administrator 9/9/21

Early transition to oral antibiotic therapy for community-acquired pneumonia: duration of therapy, clinical outcomes, and cost analysis

Conversion – CAP pts randomized to conventional course of IV antibiotics vs. abbreviated course of IV antibiotics followed by conversion to oral antibiotics conversion-CAP pts randomized to conventional course of IV antibiotics vs. abbreviated course of IV antibiotics followed by conversion to oral antibiotics.

Adventure Administrator 9/8/21 Adventure Administrator 9/8/21

A pharmacist-initiated program of intravenous to oral antibiotic conversion

Conversion – Pharmacists contacted physicians to recommend oral antibiotics conversions from selected broad-spectrum and high-cost parenteral antibiotics for patients with predetermined mild to moderate clinical conditions.

Adventure Administrator 9/7/21 Adventure Administrator 9/7/21

Cost-effectiveness of prospective and continuous parenteral antibiotic control: experience at the Palo Alto Veterans Affairs Medical Center from 1987 to 1989

Multidisciplinary – Implementation of new restrictions in antibiotic formulary for broad-spectrum antibiotics and restrictions for antibiotics maximum daily dosage.

Adventure Administrator 9/6/21 Adventure Administrator 9/6/21

Reduction of incorrect antibiotic dosing through a structured educational order form.

Order form – Creation of an order form with preset dosing orders for clindamycin, cefazolin and metronidazole. Physicians still had option to choose own dosing schedule on the form.

Adventure Administrator 9/5/21 Adventure Administrator 9/5/21

Antibiotic streamlining from combination therapy to monotherapy utilizing an interdisciplinary approach

Streamlining – Patients on two or more empiric parenteral antibiotics identified by nursing unit pharmacist, results shared with ID physician, who then called prescribing physician to suggest alternative monotherapy.

Adventure Administrator 9/4/21 Adventure Administrator 9/4/21

Antibiotic cost savings from formulary restrictions and physician monitoring in a medical-school-affiliated hospital

Restriction-creation of formulary restrictions for vancomycin and select aminoglycocides and cephalosporins, which would require obtaining ID approval for use. ID told not to reject requests but to use persuasion.

Adventure Administrator 9/3/21 Adventure Administrator 9/3/21

Controlling cephalosporin and aminoglycoside costs through pharmacy and therapeutics committee restrictions

Guidelines – Established restrictions on use of 2nd generation cephalosporins and aminoglycosides requiring obtaining pharmacy approval before drug disbursement

Adventure Administrator 9/2/21 Adventure Administrator 9/2/21

Reduction in antibiotic costs by restricting use of an oral cephalosporin

Restriction-All physicians wanting to prescribe cephalexin had to seek approval from ID physician.

Adventure Administrator 9/1/21 Adventure Administrator 9/1/21

Cost containment through restriction of cephalosporins

Guidelines – Establishment of guidelines that cefazolin is cephalosporin of choice. Physicians contacted if orders deemed to be noncompliant.