Antibiotic stewardship in small community hospital.
Chest. 2014 Mar 1;145(3 Suppl):146A
Authors: Udeani G, Surani S
SESSION TITLE: Respiratory Infections PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Linezolid is a novel oxazolidine antibiotic with activity against methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant enterococci (VRE) and penicillin-resistant Streptococcus pneumonia, besides activity against Clostridium perfingens, Clostridium difficle, Peptostreptococcus spp., and Bacteroides fragilis. With the emergence of multi-drug resistant organism efforts have been directed towards antibiotics stewardship. We conducted a retrospective chart review in a small community hospital to evaluate the pattern of use of linezolid based on institutional guidelines.
METHODS: Retrospective chart review of 25 patients who received linezolid after appropriate institutional review board approval was conducted. Clinical demographic data, as well as data on physician usage patterns of linezolid and other comparable antibiotics were collected. Cost analysis summary was also carried out.
RESULTS: Mean patient age was 60.88 +/- 16.93 and mean creatinine was 0.97mg/dl +/- 0.74. Majority of linezolid usage was for cellulitis. Only 2 patients with VRE and 2 patients with Vancomycin allergy and one patient with renal transplant qualified for linezolid based on the institutional guidelines. 20 out of 25 patients treated with linezolid qualified for other forms of therapy for the management of gram positive infections. Cost of Linezolid was $22,417 versus $2995 for Vancomycin and monitoring cost.
CONCLUSIONS: In the era of rising health care cost, physicians need to explore other cost effective modality of therapy, and moreover the newer antibiotics effective against resistant organism should be used judiciously to prevent the emergence of resistance against those antibiotics.
CLINICAL IMPLICATIONS: Physicians need to be continuously educated regarding antibiotic stewardship and institutional policies regarding antibiotics need to be designed.
DISCLOSURE: The following authors have nothing to disclose: George Udeani, Salim SuraniNo Product/Research Disclosure Information.
PMID: 24638318 [PubMed - in process]