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September 05, 2008

When it comes to antibiotics, less is more: no-pay rules for hospital-acquired infections motivate change in prescribing behavior

About 15 years ago, someone I knew was active in an organization called the Society for the Prevention of Overuse of Antibiotics (or something like that).  While this has long been an issue of concern, back then it seemed a decidedly fringe issue.  Fast-forward to the MRSA superbug and no-pay rules for hospital-acquired infections, and reduction in the use of broad-spectrum antibiotics is a decidedly mainstream effort.  Premier is on the case; VHA has a "Bugs and Drugs" program for its member hospitals which, the Wall Street Journal reports this week in a piece on antimicrobial stewardship programs can yield concrete results in a relatively short timeframe:

Some hospitals have measured tangible benefits. Hunterdon Medical Center in Flemington, N.J., a 178-bed community hospital affiliated with VHA, joined the Bugs and Drugs program in 2006. The hospital developed guidelines for the most commonly overused antibiotics, and routinely tests bacteria from its facility to determine their susceptibility to drugs in its formulary. In a 2007 test, Hunterdon found that 51% of cultures of Klebsiella pneumoniae, which causes pneumonia, urinary tract and wound infections, were susceptible to ciprofloxacin, up from 27% a year earlier. Over the period the susceptibility to antibiotics of another infection-causing bacteria, Pseudomonas aeruginosa, rose to 79% from 54%.

This is the sort of effort that can both improve outcomes and reduce costs in the health care system, and should be part and parcel of the widespread effort to get a handle on hospital-acquired infections, which was the topic of a HealthBlawg post earlier this week.

-- David Harlow

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