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Practices to Improve Antimicrobial Use at 47 US Hospitals: The Status of the 1997 SHEA/IDSA Position Paper Recommendations

Rachel M. Lawton , MPH, Scott K. Fridkin , MD, Robert P. Gaynes , MD, John E. McGowan , Jr, MD and Intensive Care Antimicrobial Resistance Epidemiology (ICARE) Hospitals
Infection Control and Hospital Epidemiology
Vol. 21, No. 4 (April 2000), pp. 256-259
DOI: 10.1086/501754
Stable URL: http://www.jstor.org/stable/10.1086/501754
Page Count: 4
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Practices to Improve Antimicrobial Use at 47 US Hospitals: The Status of the 1997 SHEA/IDSA Position Paper Recommendations
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Abstract

OBJECTIVE.  To determine the status of programs to improve antimicrobial prescribing at select US hospitals. DESIGN.  Cross‐sectional survey. PARTICIPANTS AND SETTING.  Pharmacy and infection control staff at all 47 hospitals participating in phase 3 of Project Intensive Care Antimicrobial Resistance Epidemiology. RESULTS.  All 47 hospitals had some programs to improve antimicrobial use, but the practices reported varied considerably. All used a formulary, and 43 (91%) used it in conjunction with at least one of the other three antimicrobial‐use policies evaluated: stop orders, restriction, and criteria‐based clinical practice guidelines (CPGs). CPGs were reported most commonly (70%), followed by stop orders (60%) and restriction policies (40%). Although consultation with an infectious disease physician (70%) or pharmacist (66%) was commonly used to influence initial antimicrobial choice, few (40%) reported a system to measure compliance with these consultations. CONCLUSIONS.  In most hospitals surveyed, practices to improve antimicrobial use, although present, were inadequate based on recommendations in a Society for Healthcare Epidemiology of America and Infectious Disease Society of America joint position paper. There is room to improve antimicrobial‐use stewardship at US hospitals.

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