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Impact of a pediatric antimicrobial stewardship program in an academic medical center

Published on: 2020-04-09

Abstract

Purpose: To evaluate the clinical and financial impact of a pediatric infectious disease pharmacist, during the initiation of an inpatient antimicrobial stewardship program (ASP) at an academic pediatric institution, to support judicious antimicrobial use through restricted antimicrobial approval, prospective-audit-and-feedback of patients receiving antimicrobials, and review of microbiology laboratory results.
Summary: A pediatric ASP utilizing prospective audit and feedback was developed and implemented at Doernbecher Children’s Hospital (DCH) at Oregon Health & Science University (OHSU) in October 2017. As a key contributing member of the pediatric ASP, the pediatric infectious disease pharmacist demonstrated value to the pharmacy enterprise by making clinical optimization interventions related to antimicrobial therapy. Measures included antibiotic utilization and associated cost as well as intervention type and potential cost avoidance to the health-system.
Conclusion: The implementation of a pediatric ASP at DCH consists of leadership commitment, accountability, drug expertise, action, tracking, reporting, and education. Tracked and trended data since program implementation has demonstrated high rates of proposed interventions from the pediatric clinical pharmacist and high acceptance rates of those interventions by physician clinical teams. This has resulted in a decrease in days-of-therapy per 1000 patient days and significant cost avoidance to the pharmacy enterprise without increasing hospital readmission rates.

Keywords

Prospective-audit-and-feedback; stewardship; pediatric; intervention; utilization