Impact of Infectious Diseases Team Consultation on Antimicrobial Use, Length of Stay and Mortality.
BACKGROUND
Infectious disease (ID) clinicians and multidisciplinary teams may have a beneficial impact on patient outcomes. This study was conducted to determine the impact of dedicated ID team rounding in an adult noncardiac intensive care unit (ICU) on antimicrobial costs, length of stay and mortality.


METHODS
The authors instituted dedicated ICU ID team rounds at a large tertiary care hospital ICU ("intervention"), with the ID team conducting rounds in the ICU every weekday. The authors compared the cost of antimicrobial agents, total hospital and ICU length of stay and inpatient mortality for the 6-month period before and after institution of these rounds between those seen versus those not seen by the ID team.


RESULTS
Among 386 patients analyzed, 206 were admitted in the preintervention and 180 in the postintervention period. Among those seen by the ID team, there was an 18% decrease in total antimicrobial cost (P < 0.0001), 40% decrease in ICU length of stay (P = 0.1), 33% decrease in overall hospital length of stay (P = 0.03) and 34% decrease in mortality (0.04) from preintervention to postintervention period. Among those not seen by ID, there was a 39% decrease in cost among those not seen by ID (P < 0.0001), but length of ICU or hospital stay and mortality were not significantly different.


CONCLUSIONS
Institution of dedicated ID team rounding in the ICU leads to substantial decreases in antimicrobial costs, hospital length of stay and inpatient mortality among those patients seen by the team.
Hamad Healthcare Quality Institute (AAB), Hamad Medical Corporation, Doha, Qatar; Department of Medicine, University of Pittsburgh School of Medicine (AAB), Pittsburgh, Pennsylvania; Departments of Pediatrics (NAK), Department of Medicine (TK), Pharmacy (MS, MK), Critical Care Medicine (KMK, WHJ, MS), Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; and Institute of Laboratory Medicine (MP, SW), Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
Adeel A
AA
Butt
Nawal
N
Al Kaabi
Mohammed
M
Saifuddin
Kalpana M
KM
Krishnanreddy
Maqsood
M
Khan
Waleed H
WH
Jasim
Tehmina
T
Khan
Masalam
M
Sara
Marthinus
M
Pitout
Stefan
S
Weber
D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D003141:Communicable Diseases / Q000188:drug therapy / Q000401:mortality; D003422:Critical Care / Q000379:methods*; D016527:Drug Costs; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration / Q000706:statistics & numerical data*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D014479:United Arab Emirates
D000890:Anti-Infective Agents