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The Economic Impact of Starting, Stopping, and Restarting an Antibiotic Stewardship Program: A 14-Year Experience
Regions Hospital, St. Paul, MN 55101, USA
Antibiotic Pharmacodynamic Research Institute, University of Minnesota College of Pharmacy, Minneapolis, MN 55455, USA
University of Minnesota, Minneapolis, MN 55455, USA
South Carolina College of Pharmacy, Charleston, SC 29208, USA
Medical University of South Carolina College of Medicine, Charleston, SC 29208, USA
Formerly associated with Regions Hospital, St. Paul, MN 55101, USA.
* Author to whom correspondence should be addressed.
Received: 17 February 2013; in revised form: 11 April 2013 / Accepted: 15 April 2013 / Published: 24 April 2013
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.
Keywords: antimicrobials; antibiotic costs; stewardship; resistance
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Ullman, M.A.; Parlier, G.L.; Warren, J.B.; Mateo, N.; Harvey, C.; Sullivan, C.J.; Bergsbaken, R.; Mitropoulos, I.F.; Bosso, J.A.; Rotschafer, J.C. The Economic Impact of Starting, Stopping, and Restarting an Antibiotic Stewardship Program: A 14-Year Experience. Antibiotics 2013, 2, 256-264.
Ullman MA, Parlier GL, Warren JB, Mateo N, Harvey C, Sullivan CJ, Bergsbaken R, Mitropoulos IF, Bosso JA, Rotschafer JC. The Economic Impact of Starting, Stopping, and Restarting an Antibiotic Stewardship Program: A 14-Year Experience. Antibiotics. 2013; 2(2):256-264.
Ullman, Mary A.; Parlier, Garry L.; Warren, James B.; Mateo, Noe; Harvey, Craig; Sullivan, Christopher J.; Bergsbaken, Robert; Mitropoulos, Isaac F.; Bosso, John A.; Rotschafer, John C. 2013. "The Economic Impact of Starting, Stopping, and Restarting an Antibiotic Stewardship Program: A 14-Year Experience." Antibiotics 2, no. 2: 256-264.