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133. A Review of Antimicrobial Formularies at Rural Hospitals: Stewardship Opportunities Abound

BACKGROUND: Management of a hospital’s antimicrobial formulary is an important aspect of antimicrobial stewardship and cost containment strategies. Ensuring that essential medications for clinical care are available and excluding therapeutic duplicates and unnecessary antimicrobials is time and reso...

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Autores principales: Bulger, Peter, Castillo, Alyssa Y, Lynch, John B, Pottinger, Paul, Chan, Jeannie D, Jain, Rupali, Naderi, Mandana, Kassamali, Zahra, Bryson-Cahn, Chloe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8644038/
http://dx.doi.org/10.1093/ofid/ofab466.335
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author Bulger, Peter
Castillo, Alyssa Y
Lynch, John B
Lynch, John B
Pottinger, Paul
Chan, Jeannie D
Jain, Rupali
Naderi, Mandana
Kassamali, Zahra
Bryson-Cahn, Chloe
author_facet Bulger, Peter
Castillo, Alyssa Y
Lynch, John B
Lynch, John B
Pottinger, Paul
Chan, Jeannie D
Jain, Rupali
Naderi, Mandana
Kassamali, Zahra
Bryson-Cahn, Chloe
author_sort Bulger, Peter
collection PubMed
description BACKGROUND: Management of a hospital’s antimicrobial formulary is an important aspect of antimicrobial stewardship and cost containment strategies. Ensuring that essential medications for clinical care are available and excluding therapeutic duplicates and unnecessary antimicrobials is time and resource intensive. Comparisons of antimicrobial formularies across multiple rural hospitals have not been evaluated in the literature. We hypothesized that a comprehensive formulary evaluation would reveal important opportunities for antimicrobial stewardship efforts and could help smaller hospitals optimize available medications. METHODS: The University of Washington Tele-Antimicrobial Stewardship Program (UW-TASP) is comprised of 68 hospitals of varying sizes, most of which are rural and critical access, in Washington, Oregon, Arizona, Idaho, and Utah. We surveyed UW-TASP participating hospitals and other networked rural hospitals in multiple Western states using REDCap, a HIPAA-compliant, electronic data management program. Respondents reported which antimicrobials are on their hospital formulary as well as basic information about hospital size and inpatient units. Data were reviewed by a panel of infectious diseases trained physicians and pharmacists at UW-TASP. RESULTS: Surveys from 49 hospitals were received; two were excluded from the data analysis (Table 1) – one submission was incomplete, and one was a large inpatient psychiatric hospital. Select antimicrobials and proportion of hospitals carrying these agents is shown in Table 2. Several antimicrobials are on the formulary at all hospitals, regardless of size. In some critical access hospitals (< 25 beds), empiric first-line bacterial meningitis and viral encephalitis coverage (Table 3) was lacking. Six hospitals (12.7%) lacked ampicillin for Listeria coverage and only one had a suitable alternative agent (meropenem). Seven hospitals (14.9%) lacked intravenous acyclovir, although three had oral valacyclovir. Formulary inclusion of agents for multi-drug resistant organisms was rare. [Image: see text] [Image: see text] [Image: see text] CONCLUSION: In critical access hospitals in the Western USA, lack of essential empiric antimicrobials may be more of a concern than inclusion of agents with unnecessarily broad spectra. DISCLOSURES: Chloe Bryson-Cahn, MD, Alaska Airlines (Other Financial or Material Support, Co-Medical Director, position is through the University of Washington)
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spelling pubmed-86440382021-12-06 133. A Review of Antimicrobial Formularies at Rural Hospitals: Stewardship Opportunities Abound Bulger, Peter Castillo, Alyssa Y Lynch, John B Lynch, John B Pottinger, Paul Chan, Jeannie D Jain, Rupali Naderi, Mandana Kassamali, Zahra Bryson-Cahn, Chloe Open Forum Infect Dis Poster Abstracts BACKGROUND: Management of a hospital’s antimicrobial formulary is an important aspect of antimicrobial stewardship and cost containment strategies. Ensuring that essential medications for clinical care are available and excluding therapeutic duplicates and unnecessary antimicrobials is time and resource intensive. Comparisons of antimicrobial formularies across multiple rural hospitals have not been evaluated in the literature. We hypothesized that a comprehensive formulary evaluation would reveal important opportunities for antimicrobial stewardship efforts and could help smaller hospitals optimize available medications. METHODS: The University of Washington Tele-Antimicrobial Stewardship Program (UW-TASP) is comprised of 68 hospitals of varying sizes, most of which are rural and critical access, in Washington, Oregon, Arizona, Idaho, and Utah. We surveyed UW-TASP participating hospitals and other networked rural hospitals in multiple Western states using REDCap, a HIPAA-compliant, electronic data management program. Respondents reported which antimicrobials are on their hospital formulary as well as basic information about hospital size and inpatient units. Data were reviewed by a panel of infectious diseases trained physicians and pharmacists at UW-TASP. RESULTS: Surveys from 49 hospitals were received; two were excluded from the data analysis (Table 1) – one submission was incomplete, and one was a large inpatient psychiatric hospital. Select antimicrobials and proportion of hospitals carrying these agents is shown in Table 2. Several antimicrobials are on the formulary at all hospitals, regardless of size. In some critical access hospitals (< 25 beds), empiric first-line bacterial meningitis and viral encephalitis coverage (Table 3) was lacking. Six hospitals (12.7%) lacked ampicillin for Listeria coverage and only one had a suitable alternative agent (meropenem). Seven hospitals (14.9%) lacked intravenous acyclovir, although three had oral valacyclovir. Formulary inclusion of agents for multi-drug resistant organisms was rare. [Image: see text] [Image: see text] [Image: see text] CONCLUSION: In critical access hospitals in the Western USA, lack of essential empiric antimicrobials may be more of a concern than inclusion of agents with unnecessarily broad spectra. DISCLOSURES: Chloe Bryson-Cahn, MD, Alaska Airlines (Other Financial or Material Support, Co-Medical Director, position is through the University of Washington) Oxford University Press 2021-12-04 /pmc/articles/PMC8644038/ http://dx.doi.org/10.1093/ofid/ofab466.335 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Poster Abstracts
Bulger, Peter
Castillo, Alyssa Y
Lynch, John B
Lynch, John B
Pottinger, Paul
Chan, Jeannie D
Jain, Rupali
Naderi, Mandana
Kassamali, Zahra
Bryson-Cahn, Chloe
133. A Review of Antimicrobial Formularies at Rural Hospitals: Stewardship Opportunities Abound
title 133. A Review of Antimicrobial Formularies at Rural Hospitals: Stewardship Opportunities Abound
title_full 133. A Review of Antimicrobial Formularies at Rural Hospitals: Stewardship Opportunities Abound
title_fullStr 133. A Review of Antimicrobial Formularies at Rural Hospitals: Stewardship Opportunities Abound
title_full_unstemmed 133. A Review of Antimicrobial Formularies at Rural Hospitals: Stewardship Opportunities Abound
title_short 133. A Review of Antimicrobial Formularies at Rural Hospitals: Stewardship Opportunities Abound
title_sort 133. a review of antimicrobial formularies at rural hospitals: stewardship opportunities abound
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8644038/
http://dx.doi.org/10.1093/ofid/ofab466.335
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