Antimicrobial Stewardship Update-AzHHA Conference Call

Re-Cap of Previous Conference Call: • Why should we develop AMS Programs? • What are some components of an AMS Program?

• Who should participate on your AMS Committee?

• Examples of Guidelines, Use of Data, Financial Information and PI Opportunities

• Examples of barriers for AMS programs

Recommended Components of an Antimicrobial Stewardship Program

Foundation = 2 core, proactive strategies

Prospective audit with intervention and feedback Formulary restriction and preauthorization

Dellit TH, Owens RC, McGowan JE, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 44 (1): 159-177, 2007.

BEST PRACTICE

Financial analysis

Antimicrobial expenditures: $6.3 million/year

Conservative savings with appropriate

utilization: 20% = $1.26 million per year

Improve utilization by implementing antibiotic stewardship BEST PRACTICES; Needed resources:

Pharmacist: $144,000/yr (salary/benefits) Physician Leader: $220,000/yr (salary/benefits) TOTAL = $364,000/yr

(additional $ might be needed for IT support)

Potential savings per year = $896,000 (ROI = 250%)

Next Steps1. Re-evaluate physician leadership: ID physician group agrees to

work with pharmacy on AMS program….($$)

2. Formulary evaluation: caspofungin vs. micafungin vs. anidulafungin

3. Transition from faculty ID pharmacist leadership to SHC pharmacy clinical staff: Shea pharmacy clinical coordinator

to provide leadership (Dennis Snow, Pharm.D., BCPS)

4. Explore expansion of pharmacist clinical duties to include antimicrobial stewardship responsibilities: Involvement of

clinical pharmacist specialists and residents

5. Add Pharmacist to Infection Prevention/Control Committee

6. Improvement of the 2 core proactive strategies

Antimicrobial Stewardship

Closure Thoughts:

Need to continually evaluate organizational support for the program

Support of Hospitalists, Intensivists and Infectious Disease MDs

is key Clear, succinct data presentation creates value at all

levels

Questions?