Update on antimicrobial stewardship initiative

22 Jan 2017

By: Jasmin Chaudhary, MD

 

The Joint Commission recently announced a new Medication Management (MM) standard for hospitals and critical access hospitals, addressing antimicrobial stewardship. These new standards became effective Jan. 1, 2017. CMS has also written new proposed rules, adding antimicrobial stewardship to the existing Infection Prevention Conditions of Participation for Medicare. 

In response to these changes and our A3 focus this year, an infectious disease pharmacist has joined our staff, and an antibiotic stewardship steering committee was created in October 2016. This team (including infectious disease physicians and other providers, pharmacists, infection preventionists, Kaizen Consultant, Business Intelligence, and Educator) is helping lead a hospital-wide antibiotic stewardship program (ASP) initiative. We are targeting a 10 percent reduction in use of five specific drugs this year, including ciprofloxacin, vancomycin, levofloxacin, meropenem, and Zosyn. This work will reduce our rate of hospital-acquired clostridium difficile infections, reduce drug costs, decrease length of hospital stay and prevent drug resistance. 

Current improvement initiatives:

1. Implementation of an expanded anti-infective restricted formulary, go live date of Feb. 1, 2017.
2. Changes to the IV to PO pharmacy guideline regarding antibiotic therapy.
3. Modified screening criteria for sputum for culture so only those indicative of bacterial pneumonia are cultured.  Samples with rare or no organisms on gram stains will no longer be cultured.
4. Implementation of a C-diff testing algorithm for expedited C-diff testing.
   
5. Release of fluoroquinolone sensitivities in regards to Staph Aureus bacteremia will be available upon request only.