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Antibiotic Stewardship: Correct Drug, De-escalation of therapy, Discontinuation of therapy, Correct Dose, and Diagnosis
Antibiotic stewardship was implemented in 2011 and focuses on five 'D's': Drug, De-escalation of therapy, Discontinuation of therapy, Dose and Diagnosis. The pharmacy department automatically adjusts therapy based on patient's renal function and enforces restrictions on certain antibiotics. All of the restricted antibiotics require infectious disease physician approval prior to being verified by a pharmacist. Pharmacists enter a 7-day hard stop date on all antibiotics, unless otherwise specified by the prescribing physician. The laboratory department also utilizes the Verigene BC-GP test on all blood cultures with a gram positive stain and then reports the testing results to a pharmacist. The pharmacist then notifies the physician if antibiotic therapy is needed to be streamlined or adjusted based on the microorganism. The health system reviews antibiotic usage along with C.diff rates through regular meetings of the infection control dommittee. Appropriateness of antimicrobial therapy is also reviewed during Intensive Care daily patient care rounds.
Antibiotic stewardship was implemented in 2011 and focuses on five 'D's': Drug, De-escalation of therapy, Discontinuation of therapy, Dose and Diagnosis. The pharmacy department automatically adjusts therapy based on patient's renal function and enforces restrictions on certain antibiotics. All of the restricted antibiotics require infectious disease physician approval prior to being verified by a pharmacist. Pharmacists enter a 7-day hard stop date on all antibiotics, unless otherwise specified by the prescribing physician. The laboratory department also utilizes the Verigene BC-GP test on all blood cultures with a gram positive stain and then reports the testing results to a pharmacist. The pharmacist then notifies the physician if antibiotic therapy is needed to be streamlined or adjusted based on the microorganism. The health system reviews antibiotic usage along with C.diff rates through regular meetings of the infection control dommittee. Appropriateness of antimicrobial therapy is also reviewed during Intensive Care daily patient care rounds.
This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state. These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.
Award recipients achieve measurable and meaningful progress in providing care that is:
- Safe
- Timely
- Effective
- Efficient
- Equitable
- Patient-centered
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