title: Impact of an Antimicrobial Stewardship Program on Unnecessary Double Anaerobic Coverage Prescription.
abstract: BACKGROUND
  Co-administration of two or more antimicrobials with anti-anaerobic activity is not recommended except in certain circumstances. We therefore conducted an intervention to reduce unnecessary double anaerobic coverage (DAC) prescription.
  
  
  METHODS
  The intervention consisted of education using an institutional intranet and prospective audits and feedback provided through collaboration between a pharmacist and an infectious diseases physician in Seoul National University Bundang Hospital, a tertiary hospital in Seongnam, Republic of Korea, in 2013. The study period was 1 year which contained 6 months of pre-intervention period and 6 months of intervention period. To estimate the overall effect of the intervention, we compared the monthly number of patients receiving unnecessary DAC for more than 3 days and the proportion of patients receiving unnecessary DAC for more than 3 days among all patients receiving DAC.
  
  
  RESULTS
  The average monthly number of patients receiving unnecessary DAC for more than 3 days after screening decreased by 73.9% in the intervention period from 26.8 to 7.0. Wilcoxon rank sum test revealed there was a significant statistical difference in the monthly number of patients receiving unnecessary DAC for more than 3 days (P = 0.005). The proportion of patients receiving unnecessary DAC for more than 3 days after screening among all patients identified as receiving necessary or unnecessary DAC also decreased by 67.8% in the intervention period from 42.3% to 13.6% (P < 0.001).
  
  
  CONCLUSIONS
  The multidisciplinary antimicrobial stewardship program with combined methods reduced unnecessary DAC prescription successfully.
authors.affiliation: Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Moonsuk
authors.initials: M
authors.lastname: Kim
authors.affiliation: Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Saemi
authors.initials: S
authors.lastname: Huh
authors.affiliation: Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Junghwa
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Eunsook
authors.initials: E
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyoung-Ho
authors.initials: KH
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Eu Suk
authors.initials: ES
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hong Bin
authors.initials: HB
authors.lastname: Kim
keywords: Anaerobic bacteria; Antimicrobial stewardship program; Inappropriate prescribing