A Randomized, Prospective Study Measuring Outcomes after Antibiotic Therapy Intervention by a Multidisciplinary Consult Team

Our aim was to identify financial and outcome benefits of therapeutic intervention by a multidisciplinary antimicrobial treatment team composed of pharmacists, a clinical microbiologist, and an infectious disease specialist. Of 252 consecutive inpatients receiving suboptimal intravenous antibiotics...

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Bibliographic Details
Published in:	Pharmacotherapy Vol. 19; no. 12; pp. 1369 - 1377
Main Authors:	Gums, John G., Yancey Jr, Robert W., Hamilton, Carol A., Kubilis, Paul S.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-12-1999 Pharmacotherapy
Subjects:	Aged Anti-Bacterial Agents - economics Anti-Bacterial Agents - therapeutic use Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Biological and medical sciences Communicable Diseases - drug therapy Communicable Diseases - economics Cost of Illness Economics, Hospital Humans Infusions, Intravenous Length of Stay Medical sciences Patient Care Team Pharmacology. Drug treatments Prospective Studies Survival Rate Treatment Outcome Human Infection Antibiotic Chemotherapy Costs Treatment Intravenous administration Hospital consultation Health economy Hospital Antibacterial agent Multidisciplinary
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Summary:	Our aim was to identify financial and outcome benefits of therapeutic intervention by a multidisciplinary antimicrobial treatment team composed of pharmacists, a clinical microbiologist, and an infectious disease specialist. Of 252 consecutive inpatients receiving suboptimal intravenous antibiotics identified by the clinical pharmacist, 127 were prospectively randomized to intervention and 125 to a control group. The groups were similar with regard to severity of illness, infection type, and time from admission to randomization. Physicians received timely, detailed reviews of relevant microbiologic and clinical data with recommendations of possible optimal antibiotic choices, dosages, and rationales. Median length of stay after randomization for control and intervention groups was 9.0 days and 5.7 days, respectively (3.3‐day difference, p=0.0001). Fifteen (12.0%) and eight patients (6.3%), respectively, died, although the time‐specific mortality risk was not significantly different when length of postrandomization follow‐up and time to death were taken into account. Physician acceptance of suggestions was 89%. Median patient charges for radiology, laboratory, pharmacy, and room were reduced by $4404/intervention, and median hospital costs were reduced by $2642/intervention. A multidisciplinary antimicrobial therapy team can be a useful information source for physicians, improve outcomes in hospitalized patients receiving intravenous antimicrobials, and result in substantial cost savings.
Bibliography:	ark:/67375/WNG-B2LCZJPG-6 istex:1BDFA33B708E611469DEE50C1A8C75E62D21FF04 ArticleID:PHAR2184 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23
ISSN:	0277-0008 1875-9114
DOI:	10.1592/phco.19.18.1369.30898