The Economic Impact of Antimicrobial Overuse
A recent study published in Infection Control and Hospital Epidemiology quantified the prevalence and economic impact of redundant antimicrobial therapy in U.S. hospitals. Leslie Schultz, PhD, et al. conducted a retrospective analysis of inpatient administrative data taken from 505 nonfederal U.S. hospitals between January 2008 and December 2011. The authors ultimately found evidence of inappropriate antimicrobial coverage for 23 different antimicrobial combinations in 78 percent of the hospitals. Additionally, the authors observed:
- High-frequency redundancies in three anti-anaerobic regimens in 70 percent of the cases analyzed
- Of this 70 percent, metronidazole and piperacillin-tazobactam accounted for 53 percent of potentially redundant cases
- Redundant therapy totaled 148,589 days, equating to $12 million in potentially avoidable healthcare costs
This study highlights the extent of the overuse and inappropriate use of antimicrobials in the U.S., which was formally recognized last week as a major public health issue by President Obama in his Executive Order on Antibiotic Resistance. Additionally, the Society for Healthcare Epidemiology of America, Infectious Diseases Society of America and Pediatric Infectious Diseases Society released a combined policy statement declaring that all healthcare institutions are responsible for practicing in a manner consistent with antimicrobial stewardship, an effective strategy in combating rising rates of antimicrobial resistance along with wasteful spending and patient harm.
Schultz et al. Economic Impact of Redundant Antimicrobial Therapy in US Hospitals. Infect Control Hosp Epidemiol 2014; 35(10): 1229-1235.