Practices to improve antimicrobial use at 47 US hospitals: the status of the 1997 SHEA/IDSA position paper recommendations. Society for Healthcare Epidemiology of America/Infectious Diseases Society of America.
OBJECTIVE
To determine the status of programs to improve antimicrobial prescribing at select US hospitals.


METHODS
Cross-sectional survey.


METHODS
Pharmacy and infection control staff at all 47 hospitals participating in phase 3 of Project Intensive Care Antimicrobial Resistance Epidemiology.


RESULTS
All 47 hospitals had some programs to improve antimicrobial use, but the practices reported varied considerably. All used a formulary, and 43 (91%) used it in conjunction with at least one of the other three antimicrobial-use policies evaluated: stop orders, restriction, and criteria-based clinical practice guidelines (CPGs). CPGs were reported most commonly (70%), followed by stop orders (60%) and restriction policies (40%). Although consultation with an infectious disease physician (70%) or pharmacist (66%) was commonly used to influence initial antimicrobial choice, few (40%) reported a system to measure compliance with these consultations.


CONCLUSIONS
In most hospitals surveyed, practices to improve antimicrobial use, although present, were inadequate based on recommendations in a Society for Healthcare Epidemiology of America and Infectious Disease Society of America joint position paper. There is room to improve antimicrobial-use stewardship at US hospitals.
Lawton
R M
RM
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Fridkin
S K
SK
Gaynes
R P
RP
McGowan
J E
JE
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000517:prevention & control*; D004352:Drug Resistance, Microbial; D005572:Formularies, Hospital as Topic; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D017053:Infection Control; D017410:Practice Guidelines as Topic; D014481:United States; D003245:Consensus Statements as Topic
D000900:Anti-Bacterial Agents