Information intervention to decrease inappropriate antibiotic use

L. A. Grohskopf, J. B. Purcell, D. Bell, P. Wareham, Thomas Hooton

Research output: Contribution to journalArticle

Abstract

Inappropriate antibiotic use negatively impacts health care costs and resistance. Simple, non-intrusive, and effective means of impacting prescribing patterns are needed. We report a successful method which may generalize to other situations. In 1988, tobramycin (T, $7.26/120 mg) accounted for >30% of aminoglycoside doses dispensed at our facility, despite gentamicin's (G, $0.15/120 mg) similar in vitro susceptibility profile. A feedback intervention was instituted, aimed at reducing T to ≤ 15% of aminoglycoside doses. For each new T order, a pharmacist placed an adhesive label in the patient's medical record comparing costs of each agent and encouraging use of G if appropriate. Pharmacists did not review microbiologic data or personally contact physicians. The proportion of T/(T+G) doses dispensed was assessed quarterly, and the intervention was reapplied for 2- to 3-month periods when T/(T+G) was found to be >15%. Results are shown below (*= intervention periods). We have seen similar efficacy in similar interventions Period Months T/(T+G) Doses % Δ% (95% CI) 6/1/88-8/15/88 2.5 942 / 3037 31.0 -*8/16/88-10/31/88 2.5 1051 / 3895 26.9 -4.1 (-6.3, -1.9) 11/1/88-1/15/89 2.5 684 / 4257 16.1 -14.9(-16.9, -12.9) 4/1/89-6/30/89 3 757 / 3437 22.0 -*7/1/89-9/30/89 3 254 / 3333 7.6 - 4.4 (-16.1,-12.7) 10/1/89-12/31/89 3 80 / 2188 3.7 -18.3 (-19.9,-16.7) 4/1/93-6/30/93 3 366 / 2356 15.5 -*8/1/93-9/30/93 2 299/3110 9.6 -5.9 (-7.7,-4.1) designed to encourage q8 hour vs. q6 hour metronidazole dosing. We conclude that a simple chart label intervention which educates physicians as to the cost of their antibiotic choices can be effective in altering prescribing patterns.

Original languageEnglish
JournalClinical Infectious Diseases
Volume25
Issue number2
StatePublished - Dec 1 1997
Externally publishedYes

Fingerprint

Aminoglycosides
Pharmacists
Anti-Bacterial Agents
Physicians
Costs and Cost Analysis
Tobramycin
Metronidazole
Gentamicins
Health Care Costs
Adhesives
Medical Records
In Vitro Techniques

ASJC Scopus subject areas

  • Immunology

Cite this

Grohskopf, L. A., Purcell, J. B., Bell, D., Wareham, P., & Hooton, T. (1997). Information intervention to decrease inappropriate antibiotic use. Clinical Infectious Diseases, 25(2).

Information intervention to decrease inappropriate antibiotic use. / Grohskopf, L. A.; Purcell, J. B.; Bell, D.; Wareham, P.; Hooton, Thomas.

In: Clinical Infectious Diseases, Vol. 25, No. 2, 01.12.1997.

Research output: Contribution to journalArticle

Grohskopf, LA, Purcell, JB, Bell, D, Wareham, P & Hooton, T 1997, 'Information intervention to decrease inappropriate antibiotic use', Clinical Infectious Diseases, vol. 25, no. 2.
Grohskopf, L. A. ; Purcell, J. B. ; Bell, D. ; Wareham, P. ; Hooton, Thomas. / Information intervention to decrease inappropriate antibiotic use. In: Clinical Infectious Diseases. 1997 ; Vol. 25, No. 2.
@article{0936bc4726d24d698ed6c71be541be1d,
title = "Information intervention to decrease inappropriate antibiotic use",
abstract = "Inappropriate antibiotic use negatively impacts health care costs and resistance. Simple, non-intrusive, and effective means of impacting prescribing patterns are needed. We report a successful method which may generalize to other situations. In 1988, tobramycin (T, $7.26/120 mg) accounted for >30{\%} of aminoglycoside doses dispensed at our facility, despite gentamicin's (G, $0.15/120 mg) similar in vitro susceptibility profile. A feedback intervention was instituted, aimed at reducing T to ≤ 15{\%} of aminoglycoside doses. For each new T order, a pharmacist placed an adhesive label in the patient's medical record comparing costs of each agent and encouraging use of G if appropriate. Pharmacists did not review microbiologic data or personally contact physicians. The proportion of T/(T+G) doses dispensed was assessed quarterly, and the intervention was reapplied for 2- to 3-month periods when T/(T+G) was found to be >15{\%}. Results are shown below (*= intervention periods). We have seen similar efficacy in similar interventions Period Months T/(T+G) Doses {\%} Δ{\%} (95{\%} CI) 6/1/88-8/15/88 2.5 942 / 3037 31.0 -*8/16/88-10/31/88 2.5 1051 / 3895 26.9 -4.1 (-6.3, -1.9) 11/1/88-1/15/89 2.5 684 / 4257 16.1 -14.9(-16.9, -12.9) 4/1/89-6/30/89 3 757 / 3437 22.0 -*7/1/89-9/30/89 3 254 / 3333 7.6 - 4.4 (-16.1,-12.7) 10/1/89-12/31/89 3 80 / 2188 3.7 -18.3 (-19.9,-16.7) 4/1/93-6/30/93 3 366 / 2356 15.5 -*8/1/93-9/30/93 2 299/3110 9.6 -5.9 (-7.7,-4.1) designed to encourage q8 hour vs. q6 hour metronidazole dosing. We conclude that a simple chart label intervention which educates physicians as to the cost of their antibiotic choices can be effective in altering prescribing patterns.",
author = "Grohskopf, {L. A.} and Purcell, {J. B.} and D. Bell and P. Wareham and Thomas Hooton",
year = "1997",
month = "12",
day = "1",
language = "English",
volume = "25",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Information intervention to decrease inappropriate antibiotic use

AU - Grohskopf, L. A.

AU - Purcell, J. B.

AU - Bell, D.

AU - Wareham, P.

AU - Hooton, Thomas

PY - 1997/12/1

Y1 - 1997/12/1

N2 - Inappropriate antibiotic use negatively impacts health care costs and resistance. Simple, non-intrusive, and effective means of impacting prescribing patterns are needed. We report a successful method which may generalize to other situations. In 1988, tobramycin (T, $7.26/120 mg) accounted for >30% of aminoglycoside doses dispensed at our facility, despite gentamicin's (G, $0.15/120 mg) similar in vitro susceptibility profile. A feedback intervention was instituted, aimed at reducing T to ≤ 15% of aminoglycoside doses. For each new T order, a pharmacist placed an adhesive label in the patient's medical record comparing costs of each agent and encouraging use of G if appropriate. Pharmacists did not review microbiologic data or personally contact physicians. The proportion of T/(T+G) doses dispensed was assessed quarterly, and the intervention was reapplied for 2- to 3-month periods when T/(T+G) was found to be >15%. Results are shown below (*= intervention periods). We have seen similar efficacy in similar interventions Period Months T/(T+G) Doses % Δ% (95% CI) 6/1/88-8/15/88 2.5 942 / 3037 31.0 -*8/16/88-10/31/88 2.5 1051 / 3895 26.9 -4.1 (-6.3, -1.9) 11/1/88-1/15/89 2.5 684 / 4257 16.1 -14.9(-16.9, -12.9) 4/1/89-6/30/89 3 757 / 3437 22.0 -*7/1/89-9/30/89 3 254 / 3333 7.6 - 4.4 (-16.1,-12.7) 10/1/89-12/31/89 3 80 / 2188 3.7 -18.3 (-19.9,-16.7) 4/1/93-6/30/93 3 366 / 2356 15.5 -*8/1/93-9/30/93 2 299/3110 9.6 -5.9 (-7.7,-4.1) designed to encourage q8 hour vs. q6 hour metronidazole dosing. We conclude that a simple chart label intervention which educates physicians as to the cost of their antibiotic choices can be effective in altering prescribing patterns.

AB - Inappropriate antibiotic use negatively impacts health care costs and resistance. Simple, non-intrusive, and effective means of impacting prescribing patterns are needed. We report a successful method which may generalize to other situations. In 1988, tobramycin (T, $7.26/120 mg) accounted for >30% of aminoglycoside doses dispensed at our facility, despite gentamicin's (G, $0.15/120 mg) similar in vitro susceptibility profile. A feedback intervention was instituted, aimed at reducing T to ≤ 15% of aminoglycoside doses. For each new T order, a pharmacist placed an adhesive label in the patient's medical record comparing costs of each agent and encouraging use of G if appropriate. Pharmacists did not review microbiologic data or personally contact physicians. The proportion of T/(T+G) doses dispensed was assessed quarterly, and the intervention was reapplied for 2- to 3-month periods when T/(T+G) was found to be >15%. Results are shown below (*= intervention periods). We have seen similar efficacy in similar interventions Period Months T/(T+G) Doses % Δ% (95% CI) 6/1/88-8/15/88 2.5 942 / 3037 31.0 -*8/16/88-10/31/88 2.5 1051 / 3895 26.9 -4.1 (-6.3, -1.9) 11/1/88-1/15/89 2.5 684 / 4257 16.1 -14.9(-16.9, -12.9) 4/1/89-6/30/89 3 757 / 3437 22.0 -*7/1/89-9/30/89 3 254 / 3333 7.6 - 4.4 (-16.1,-12.7) 10/1/89-12/31/89 3 80 / 2188 3.7 -18.3 (-19.9,-16.7) 4/1/93-6/30/93 3 366 / 2356 15.5 -*8/1/93-9/30/93 2 299/3110 9.6 -5.9 (-7.7,-4.1) designed to encourage q8 hour vs. q6 hour metronidazole dosing. We conclude that a simple chart label intervention which educates physicians as to the cost of their antibiotic choices can be effective in altering prescribing patterns.

UR - http://www.scopus.com/inward/record.url?scp=33748156573&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748156573&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:33748156573

VL - 25

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 2

ER -