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Antimicrobial Stewardship UpdateAzHHA Conference Call
Re-Cap of Previous Conference Call:
• Why should we develop AMS Programs?
• What are some components of an AMS Program?
• Who should participate on your AMS Committee?
• Examples of Guidelines, Use of Data, Financial Information and
PI Opportunities
• Examples of barriers for AMS programs
Recommended Components of an
Antimicrobial Stewardship Program
Foundation = 2


core, proactive strategies
Prospective audit with intervention and feedback
Formulary restriction and preauthorization
Dellit TH, Owens RC, McGowan JE, et al. Infectious Diseases Society of America
and the Society for Healthcare Epidemiology of America guidelines for
developing an institutional program to enhance antimicrobial stewardship.
Clin Infect Dis. 44 (1): 159-177, 2007.
BEST PRACTICE
Financial analysis
Antimicrobial expenditures: $6.3 million/year
Conservative savings with appropriate
utilization: 20%
= $1.26 million per year
Improve utilization by implementing antibiotic stewardship
BEST PRACTICES; Needed resources:
Pharmacist:
$144,000/yr (salary/benefits)
Physician Leader: $220,000/yr (salary/benefits)
TOTAL = $364,000/yr
(additional $ might be needed for IT support)
Potential savings per year =
$896,000 (ROI = 250%)
Next Steps
1. Re-evaluate physician leadership: ID physician group agrees to work
with pharmacy on AMS program….($$)
2. Formulary evaluation: caspofungin vs. micafungin vs. anidulafungin
3. Transition from faculty ID pharmacist leadership to
SHC pharmacy clinical staff: Shea pharmacy clinical coordinator to
provide leadership (Dennis Snow, Pharm.D., BCPS)
4. Explore expansion of pharmacist clinical duties to include
antimicrobial stewardship responsibilities: Involvement of clinical
pharmacist specialists and residents
5. Add Pharmacist to Infection Prevention/Control Committee
6. Improvement of the 2 core proactive strategies
Antimicrobial Stewardship
Closure Thoughts:
 Need to continually evaluate organizational support for the
program
 Support of Hospitalists, Intensivists and Infectious Disease MDs
is key
 Clear, succinct data presentation creates value at all levels
Questions?