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Cost and health care benefits of an antimicrobial management programme

By Caron Weeks, MRPharmS, DipPharmPrac, Graeme Jones, MRCP, FRCPath, and Sarah Wyllie, MRCP, MRCPath

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Caron Weeks is directorate pharmacist for medicine and elderly care, Graeme Jones is consultant medical microbiologist and at the time of writing Sarah Wyllie was a specialist registrar in microbiology at Southampton University Hospitals NHS Trust.

ABSTRACT

OBJECTIVE — To assess the cost and health care benefits of a multidisciplinary antimicrobial management team (AMT) comprising a consultant microbiologist and a clinical pharmacist operating within the medical and care of the elderly directorates of an NHS trust.

METHODS — AMT input was assessed over a three-month period. Performance indicators were; AMT input with respect to modification of antimicrobial prescriptions, patient outcome and cost (calculated by extrapolation). A net saving to the trust was calculated from the assumption that the patients’ doctors would have made all the antimicrobial changes made by the AMT by day 3.5.

RESULTS — Assuming that the patients would have continued as per their doctor’s prescription for a further 3.5 days after the review, savings in antimicrobial acquisition costs of 42 per cent and 24 per cent were estimated in the medical directorate and care of the elderly directorate respectively. The use of intravenous antimicrobials was also reduced by 48 per cent and 40 per cent respectively.

CONCLUSION — The AMT was estimated to have reduced the cost of antimicrobial prescribing with no observed detrimental effect on patient care. The AMT reinforces good antimicrobial practice and helps educate staff.