title: The Economic Impact of Starting, Stopping, and Restarting an Antibiotic Stewardship Program: A 14-Year Experience.
abstract: Regions Hospital started a multidisciplinary antibiotic stewardship program (ASP) in 1998. The program effectively shut down from 2002-2004 as key personnel departed and was then restarted but without the dedicated pharmacist and infectious diseases physician. Purchasing data (in dollars or dollars/patient/day) unadjusted for inflation served as a surrogate marker of antibiotic consumption. These data were reviewed monthly, quarterly, and yearly along with antibiotic susceptibility patterns on a semi-annual basis. Segmented regression analysis was use to compare restricted antibiotic purchases for performance periods of 1998-2001 (construction), 2002-2004 (de-construction), and 2005-2011 (reconstruction). After 4 years (1998-2001) of operation, a number of key participants of the ASP departed. For the following three years (2002-2004) the intensity and focus of the program floundered. This trend was averted when the program was revitalized in early 2005. The construction, deconstruction, and reconstruction of our ASP provided a unique opportunity to statistically examine the financial impact of our ASP or lack thereof in the same institution. We demonstrate a significant economic impact during ASP deconstruction and reconstruction.
authors.affiliation: Regions Hospital, St. Paul, MN 55101, USA.|Antibiotic Pharmacodynamic Research Institute, University of Minnesota College of Pharmacy, Minneapolis, MN 55455, USA.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Ullman
authors.affiliation: Regions Hospital, St. Paul, MN 55101, USA.
authors.forename: Garry L
authors.initials: GL
authors.lastname: Parlier
authors.affiliation: Regions Hospital, St. Paul, MN 55101, USA.
authors.forename: James Bryan
authors.initials: JB
authors.lastname: Warren
authors.affiliation: Regions Hospital, St. Paul, MN 55101, USA.
authors.forename: Noe
authors.initials: N
authors.lastname: Mateo
authors.affiliation: Regions Hospital, St. Paul, MN 55101, USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Harvey
authors.affiliation: University of Minnesota, Minneapolis, MN 55455, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Sullivan
authors.affiliation: Regions Hospital, St. Paul, MN 55101, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Bergsbaken
authors.affiliation: Regions Hospital, St. Paul, MN 55101, USA.|Antibiotic Pharmacodynamic Research Institute, University of Minnesota College of Pharmacy, Minneapolis, MN 55455, USA.
authors.forename: Isaac F
authors.initials: IF
authors.lastname: Mitropoulos
authors.affiliation: South Carolina College of Pharmacy, Charleston, SC 29208, USA.|Medical University of South Carolina College of Medicine, Charleston, SC 29208, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Bosso
authors.affiliation: Regions Hospital, St. Paul, MN 55101, USA. rotsc001@umn.edu.|Antibiotic Pharmacodynamic Research Institute, University of Minnesota College of Pharmacy, Minneapolis, MN 55455, USA. rotsc001@umn.edu.
authors.forename: John C
authors.initials: JC
authors.lastname: Rotschafer
keywords: antibiotic costs; antimicrobials; resistance; stewardship