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A Randomized, Prospective Evaluation of an Interventional Program to Discontinue Intravenous Antibiotics at Two Tertiary Care Teaching Institutions
Author(s) -
Bailey Thomas C.,
Ritchie David J.,
McMullin S. Troy,
Kahn Michael,
Reichley Richard M.,
Casabar Ed,
Shan William,
Dunagan William Claiborne
Publication year - 1997
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1997.tb03710.x
Subject(s) - medicine , antibiotics , intravenous antibiotics , tertiary care , emergency medicine , intravenous therapy , intervention (counseling) , teaching hospital , prospective cohort study , intensive care medicine , family medicine , nursing , microbiology and biotechnology , biology
To evaluate a program to discontinue intravenous antibiotics at two teaching hospitals, 102 inpatients meeting eligibility criteria were randomly assigned to two groups. In one group, patients' physicians were contacted by pharmacists with recommendations to discontinue intravenous antibiotic therapy; in the other, patients were simply observed. Measured outcomes were antibiotic costs, length of stay, need to restart intravenous antibiotics, in‐hospital mortality, and 30‐day readmissions. The intervention significantly reduced mean antibiotic costs per patient ($19.82 vs $35.84, p=0.03), but related labor costs exceeded this benefit. Readmissions were significantly more frequent in the intervention group than in the control group (29% vs 9.8% p=0.02), but they were not infection related. No impact was demonstrated on the other measured outcomes. Institutions considering such programs or with one in place should conduct similar evaluations.