title: Outcomes associated with a thrice-weekly antimicrobial stewardship programme in a 253-bed community hospital.
abstract: OBJECTIVE
  Antimicrobial stewardship programmes (ASPs) have been shown to decrease antimicrobial resistance, reduce hospital-acquired infections and decrease overall antimicrobial expenditures. At St. Joseph Medical Center in Bellingham, WA, a thrice-weekly ASP was initiated in 2010 with the goals of decreasing carbapenem, fluoroquinolone and vancomycin use and tailoring duration of therapy.
  
  
  METHODS
  Antibiotic use per 1000 patient-days and carbapenem, fluoroquinolone and vancomycin use were evaluated pre- and post-implementation of the ASP. Total antimicrobial expenditures were evaluated for the 3 years prior to ASP implementation and three years following implementation.
  
  
  CONCLUSIONS
  Antimicrobial days of therapy per 1000 patient-days declined by 6·4% after implementation of our ASP. There was a 37% reduction in total antimicrobial expenditures after implementation. Carbapenems, vancomycin and levofloxacin use decreased considerably. Ciprofloxacin use increased during the same time period.
  
  
  CONCLUSIONS
  A thrice-weekly, pharmacist-driven ASP can decrease antimicrobial expenditure, shorten duration of therapy and decrease the utilization of carbapenems, vancomycin and levofloxacin.
authors.affiliation: Department of Pharmacy, St. Joseph Medical Center, Bellingham, WA 98225, USA.
authors.forename: N
authors.initials: N
authors.lastname: Vettese
authors.forename: J
authors.initials: J
authors.lastname: Hendershot
authors.forename: M
authors.initials: M
authors.lastname: Irvine
authors.forename: S
authors.initials: S
authors.lastname: Wimer
authors.forename: D
authors.initials: D
authors.lastname: Chamberlain
authors.forename: N
authors.initials: N
authors.lastname: Massoud
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics; D015780:Carbapenems / Q000008:administration & dosage; D003428:Cross Infection / Q000517:prevention & control; D024881:Drug Resistance, Bacterial; D024841:Fluoroquinolones / Q000008:administration & dosage; D006764:Hospitals, Community / Q000191:economics / Q000379:methods / Q000458:organization & administration; D006801:Humans; D012189:Retrospective Studies; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D024841:Fluoroquinolones; D014640:Vancomycin
keywords: antibiotics; clinical pharmacy; costs; hospital; pharmacy practice; prescribing patterns