Antibiotic stewardship program implementation varies significantly across Veterans Affairs facilities in the U.S., but a new study in Infection Control & Hospital Epidemiology shows having a clinician with formal infectious diseases training may help.
To determine variations in antimicrobial stewardship structure and practices, researchers distributed a web-based survey to 130 inpatient Veterans Affairs facilities in 2012. Highlighted below are six findings from the surveys.
1. Of the 130 facilities surveyed, 29 (22 percent) had a formal policy establishing an antimicrobial stewardship program and 12 (9 percent) had an approved antimicrobial stewardship program business plan.
2. Forty-nine facilities (38 percent) had an antimicrobial stewardship team. Of those teams, 34 included a clinical pharmacist with formal training in infectious diseases.
3. The stewardship activities that varied most across the VA facilities include yearly antibiogram development, formulary restrictions, antimicrobial duration stop orders and written clinical pathways for specific medical conditions.
4. Having at least one full-time infectious disease physician, an infectious disease fellowship program or a clinical pharmacist with formal infectious disease training was associated with decreased antimicrobial usage.
5. Conducting frequent, systematic patient-level reviews of antimicrobial use and having a policy in place to address antimicrobial use for Clostridium difficile infections was also linked to decreased antimicrobial usage.
6. Conversely, having stop orders for antimicrobial duration was actually associated with increased antimicrobial use.
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