Researchers receive grant to streamline antibiotic use at small hospitals

Published: Thursday, Aug. 15 2013 3:10 p.m. MDT

Researchers from Intermountain Medical Center have received a grant to work toward making antibiotic use more efficient and cost-effective in Utah's small community hospitals.

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MURRAY ­— Researchers from Intermountain Medical Center have received a grant to work toward making antibiotic use more efficient and cost-effective in Utah's small community hospitals.

The $786,000 grant, sponsored by Pfizer and The Joint Commission, will launch a study to examine antibiotic use and implement ways to optimize prescribing antibiotics in smaller hospitals throughout the state.

“Antibiotic stewardship programs focus on developing a structured approach to the use of antibiotics to achieve optimal outcomes,” said Dr. Eddie Stenehjem from the Department of Infectious Disease and Epidemiology at Intermountain Medical Center, the principal investigator of the study.

“In this study, we are focusing on the implementation and measuring the effectiveness of antibiotic stewardship programs in Utah’s small, community hospitals," Stenehjem said.

Researchers are primarily concerned with the overuse of antibiotics. The American College of Physicians estimates doctors prescribe 133 million courses of antibiotics each year. About 50 percent of these prescriptions are considered unnecessary since they’re prescribed for common viral infections such as a cold or cough.

To combat the overuse of antibiotics and the development of bacterial superbugs, hospitals have implemented stewardship programs.

Though larger hospitals have implemented similar programs, small hospitals generally lack antibiotic stewardship programs due to lack of personnel specializing in infectious disease treatment and varying rates of antibiotic use. Because of the lack of resources, such programs are difficult to implement.

Stenehjem and Dr. Whitney Redding, from the Department of Pharmacy at Intermountain, along with collaborators from the University of Utah, will use the grant to discover how much on-site intervention and education by physicians is needed to optimize antibiotic use in small hospitals.

Researchers hope the study will determine if there is a reduction in antibiotic use with interventions and if that results in a cost savings even with increased personnel time.

Over the next six months, Stenehjem and his team at Intermountain and the U. will begin the development phase of the study, which consists of developing an educational curriculum for doctors and pharmacists, as well as expanding IT antibiotic surveillance tools in small community hospitals.

Later, they will enter the intervention phase, which will consist of a randomized trial of 15 Intermountain Healthcare community hospitals. The phase will assign each hospital to one of three interventions, ranging from low to high resource utilization, in order to pinpoint the level of intervention needed to bring about change.

“This study will help us evaluate tools that can be used to ensure that we’re using the best antibiotics for each patient in every situation,” said Dr. Brent Wallace, chief medical officer at Intermountain Healthcare. “Using the most effective tools makes it possible to make the correct drug selection consistently. Decreasing their use helps us prevent the spread and development of superbugs, which are resistant to most of our present antibiotics.”

“This is a very innovative study in that it will extend the benefits of antimicrobial stewardship to small hospitals and evaluate how the get the most efficient impact for the resources available within a health system,” said Dr. Andrew Pavia, professor and chief of pediatric infectious diseases at the U. and associate director of the Antimicrobial Stewardship Program at Primary Children’s Medical Center.

The three purposes of the study are expanding the antibiotic utilization surveillance system, comparing antibiotic utilization rates across the Intermountain Healthcare system, and defining the most appropriate antibiotic stewardship strategy.

“This study will help us find the sweet spot for what works and what doesn’t,” Stenehjem said. “Eventually, stewardship programs will be mandatory throughout the country for all hospitals, and what we find effective in Utah will be very applicable to small community hospitals everywhere."

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