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Antibiotics 2015, 4(4), 605-616; doi:10.3390/antibiotics4040605

Remote Antimicrobial Stewardship in Community Hospitals

1
Brody School of Medicine, 600 Moye Blvd, Greenville, NC 27834, USA
2
Vidant Medical Center, 2100 Stantonsburg Rd, Greenville, NC 27834, USA
*
Author to whom correspondence should be addressed.
Academic Editors: Jerod Nagel and Angela Huang
Received: 20 September 2015 / Revised: 6 November 2015 / Accepted: 10 November 2015 / Published: 13 November 2015
(This article belongs to the Special Issue Antimicrobial Stewardship)
View Full-Text   |   Download PDF [683 KB, uploaded 13 November 2015]

Abstract

Antimicrobial stewardship has become standard practice at university medical centers, but the practice is more difficult to implement in remote community hospitals that lack infectious diseases trained practitioners. Starting in 2011, six community hospitals within the Vidant Health system began an antimicrobial stewardship program utilizing pharmacists who reviewed charts remotely from Vidant Medical Center. Pharmacists made recommendations within the electronic medical record (EMR) to streamline, discontinue, or switch antimicrobial agents. Totals of charts reviewed, recommendations made, recommendations accepted, and categories of intervention were recorded. Linear regression was utilized to measure changes in antimicrobial use over time. For the four larger hospitals, recommendations for changes were made in an average of 45 charts per month per hospital and physician acceptance of the pharmacists’ recommendations varied between 83% and 88%. There was no significant decrease in total antimicrobial use, but much of the use was outside of the stewardship program’s review. Quinolone use decreased by more than 50% in two of the four larger hospitals. Remote antimicrobial stewardship utilizing an EMR is feasible in community hospitals and is generally received favorably by physicians. As more community hospitals adopt EMRs, there is an opportunity to expand antimicrobial stewardship beyond the academic medical center. View Full-Text
Keywords: antibiotics; antimicrobials; electronic medical record; stewardship; community hospitals antibiotics; antimicrobials; electronic medical record; stewardship; community hospitals
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Wood, Z.H.; Nicolsen, N.C.; Allen, N.; Cook, P.P. Remote Antimicrobial Stewardship in Community Hospitals. Antibiotics 2015, 4, 605-616.

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