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 language | English |
|---|---|
| Journal | Clinical Infectious Diseases |
| Volume | 25 |
| Issue number | 2 |
| State | Published - Dec 1 1997 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Immunology
Cite this
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 journal › Article
}
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.
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M3 - Article
AN - SCOPUS:33748156573
VL - 25
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 2
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