title: Pharmacist involvement in antimicrobial use at rural community hospitals in four Western states.
abstract: OBJECTIVE
  Pharmacist involvement in antimicrobial use at small rural hospitals in four Western states was studied.
  
  
  METHODS
  Surveys were mailed in July 2000 to hospitals with a daily patient census of <150 in Idaho, Nevada, Utah, and eastern Washington.
  
  
  RESULTS
  Seventy-seven (77%) of 100 hospitals returned completed surveys. Only 5% of the hospitals had onsite pharmacists 24 hours per day. An onsite pharmacist was present for a median of 26 hours per week in hospitals without 24-hour pharmacist coverage (range, 0-116 hr/wk). Many hospitals (71%) had policies for monitoring or controlling antimicrobial use, but only 28% had a system capable of monitoring compliance with such policies. Few hospitals had systems for recommending changes in antimicrobial selection on the basis of susceptibility test results (27%) or for monitoring physician compliance with dosage recommendations by pharmacists (21%). Onsite pharmacist hours were significantly associated with pharmacists being involved in the initial ordering of antibiotics and providing active oversight of antimicrobial use. There was a negative correlation between onsite pharmacist hours and use of third-generation cephalosporins and carbapenems.
  
  
  CONCLUSIONS
  A survey showed that rural hospital pharmacists in four Western states spent relatively little time monitoring and influencing antimicrobial prescribing.
authors.affiliation: Qualis Health, Boise, ID 83712-7756, USA. kurts@qualishealth.org
authors.forename: Kurt B
authors.initials: KB
authors.lastname: Stevenson
authors.forename: Matthew
authors.initials: M
authors.lastname: Samore
authors.forename: James
authors.initials: J
authors.lastname: Barbera
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hannah
authors.forename: James W
authors.initials: JW
authors.lastname: Moore
authors.forename: Julie L
authors.initials: JL
authors.lastname: Gerberding
authors.forename: Peter
authors.initials: P
authors.lastname: Houck
mesh_terms: D000900:Anti-Bacterial Agents / Q000600:supply & distribution / Q000627:therapeutic use*; D015780:Carbapenems / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D003157:Community Pharmacy Services / Q000706:statistics & numerical data; D016903:Drug Monitoring / Q000379:methods; D004363:Drug Utilization / Q000706:statistics & numerical data; D006280:Health Workforce / Q000706:statistics & numerical data; D006764:Hospitals, Community; D006780:Hospitals, Rural / Q000706:statistics & numerical data; D006801:Humans; D007061:Idaho; D009505:Nevada; D010595:Pharmacists / Q000706:statistics & numerical data*; D015397:Program Evaluation / Q000379:methods; D012423:Rural Health; D011795:Surveys and Questionnaires; D013997:Time Factors; D014589:Utah; D014861:Washington
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins