Sustained savings from a longitudinal cost analysis of an internet-based preapproval antimicrobial stewardship program

Anna C. Sick, Christoph U. Lehmann, Pranita D. Tamma, Carlton K.K. Lee, Allison L. Agwu

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

objective. To evaluate an internet-based preapproval antimicrobial stewardship program for sustained reduction in antimicrobial prescribing and resulting cost savings. design. Retrospective cohort study and cost analysis. methods. Review of all doses and charges of antimicrobials dispensed to patients over 6 years (July 1, 2005-June 30, 2011) at a tertiary care pediatric hospital. results. Restricted antimicrobials account for 26% of total doses but 81% of total antimicrobial charges. Winter months (November- February) and the oncology and infant and toddler units were associated with the highest antimicrobial charges. Five restricted drugs accounted for the majority (54%) of charges but only 6% of doses. With an average approval rate of 91.5% (95% confidence interval [CI], 91.1%-91.9%), the pre approval antibiotic stewardship program saved $103,787 (95% CI, $98,583-$109,172) per year, or $14,156 (95% CI, $13,446-$14,890) per 1,000 patient-days. conclusions. A preapproval antimicrobial stewardship program effectively reduces the number of doses and subsequent charges due to restricted antimicrobials years after implementation. Hospitals with reduced resources for implementing postprescription review may benefit from a preapproval antimicrobial stewardship program. Targeting specific units, drugs, and seasons may optimize preapproval programs for additional cost savings.

Original languageEnglish (US)
Pages (from-to)573-580
Number of pages8
JournalInfection Control and Hospital Epidemiology
Volume34
Issue number6
DOIs
StatePublished - Jun 1 2013
Externally publishedYes

Fingerprint

Internet
Cost Savings
Confidence Intervals
Costs and Cost Analysis
Cohort Studies
Pediatric Hospitals
Tertiary Healthcare
Pharmaceutical Preparations
Retrospective Studies
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Sustained savings from a longitudinal cost analysis of an internet-based preapproval antimicrobial stewardship program. / Sick, Anna C.; Lehmann, Christoph U.; Tamma, Pranita D.; Lee, Carlton K.K.; Agwu, Allison L.

In: Infection Control and Hospital Epidemiology, Vol. 34, No. 6, 01.06.2013, p. 573-580.

Research output: Contribution to journalArticle

@article{f0622beb0d814f23ad367109be6c8e68,
title = "Sustained savings from a longitudinal cost analysis of an internet-based preapproval antimicrobial stewardship program",
abstract = "objective. To evaluate an internet-based preapproval antimicrobial stewardship program for sustained reduction in antimicrobial prescribing and resulting cost savings. design. Retrospective cohort study and cost analysis. methods. Review of all doses and charges of antimicrobials dispensed to patients over 6 years (July 1, 2005-June 30, 2011) at a tertiary care pediatric hospital. results. Restricted antimicrobials account for 26{\%} of total doses but 81{\%} of total antimicrobial charges. Winter months (November- February) and the oncology and infant and toddler units were associated with the highest antimicrobial charges. Five restricted drugs accounted for the majority (54{\%}) of charges but only 6{\%} of doses. With an average approval rate of 91.5{\%} (95{\%} confidence interval [CI], 91.1{\%}-91.9{\%}), the pre approval antibiotic stewardship program saved $103,787 (95{\%} CI, $98,583-$109,172) per year, or $14,156 (95{\%} CI, $13,446-$14,890) per 1,000 patient-days. conclusions. A preapproval antimicrobial stewardship program effectively reduces the number of doses and subsequent charges due to restricted antimicrobials years after implementation. Hospitals with reduced resources for implementing postprescription review may benefit from a preapproval antimicrobial stewardship program. Targeting specific units, drugs, and seasons may optimize preapproval programs for additional cost savings.",
author = "Sick, {Anna C.} and Lehmann, {Christoph U.} and Tamma, {Pranita D.} and Lee, {Carlton K.K.} and Agwu, {Allison L.}",
year = "2013",
month = "6",
day = "1",
doi = "10.1086/670625",
language = "English (US)",
volume = "34",
pages = "573--580",
journal = "Infection Control and Hospital Epidemiology",
issn = "0899-823X",
publisher = "University of Chicago Press",
number = "6",

}

TY - JOUR

T1 - Sustained savings from a longitudinal cost analysis of an internet-based preapproval antimicrobial stewardship program

AU - Sick, Anna C.

AU - Lehmann, Christoph U.

AU - Tamma, Pranita D.

AU - Lee, Carlton K.K.

AU - Agwu, Allison L.

PY - 2013/6/1

Y1 - 2013/6/1

N2 - objective. To evaluate an internet-based preapproval antimicrobial stewardship program for sustained reduction in antimicrobial prescribing and resulting cost savings. design. Retrospective cohort study and cost analysis. methods. Review of all doses and charges of antimicrobials dispensed to patients over 6 years (July 1, 2005-June 30, 2011) at a tertiary care pediatric hospital. results. Restricted antimicrobials account for 26% of total doses but 81% of total antimicrobial charges. Winter months (November- February) and the oncology and infant and toddler units were associated with the highest antimicrobial charges. Five restricted drugs accounted for the majority (54%) of charges but only 6% of doses. With an average approval rate of 91.5% (95% confidence interval [CI], 91.1%-91.9%), the pre approval antibiotic stewardship program saved $103,787 (95% CI, $98,583-$109,172) per year, or $14,156 (95% CI, $13,446-$14,890) per 1,000 patient-days. conclusions. A preapproval antimicrobial stewardship program effectively reduces the number of doses and subsequent charges due to restricted antimicrobials years after implementation. Hospitals with reduced resources for implementing postprescription review may benefit from a preapproval antimicrobial stewardship program. Targeting specific units, drugs, and seasons may optimize preapproval programs for additional cost savings.

AB - objective. To evaluate an internet-based preapproval antimicrobial stewardship program for sustained reduction in antimicrobial prescribing and resulting cost savings. design. Retrospective cohort study and cost analysis. methods. Review of all doses and charges of antimicrobials dispensed to patients over 6 years (July 1, 2005-June 30, 2011) at a tertiary care pediatric hospital. results. Restricted antimicrobials account for 26% of total doses but 81% of total antimicrobial charges. Winter months (November- February) and the oncology and infant and toddler units were associated with the highest antimicrobial charges. Five restricted drugs accounted for the majority (54%) of charges but only 6% of doses. With an average approval rate of 91.5% (95% confidence interval [CI], 91.1%-91.9%), the pre approval antibiotic stewardship program saved $103,787 (95% CI, $98,583-$109,172) per year, or $14,156 (95% CI, $13,446-$14,890) per 1,000 patient-days. conclusions. A preapproval antimicrobial stewardship program effectively reduces the number of doses and subsequent charges due to restricted antimicrobials years after implementation. Hospitals with reduced resources for implementing postprescription review may benefit from a preapproval antimicrobial stewardship program. Targeting specific units, drugs, and seasons may optimize preapproval programs for additional cost savings.

UR - http://www.scopus.com/inward/record.url?scp=84877651407&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877651407&partnerID=8YFLogxK

U2 - 10.1086/670625

DO - 10.1086/670625

M3 - Article

C2 - 23651887

AN - SCOPUS:84877651407

VL - 34

SP - 573

EP - 580

JO - Infection Control and Hospital Epidemiology

JF - Infection Control and Hospital Epidemiology

SN - 0899-823X

IS - 6

ER -