Telemedicine-Based Antimicrobial Stewardship Program Improves Prescribing, Reduces Bacterial Resistance to Antibiotics at Rural Hospital

Summary

Sonoma Valley Hospital (an 83-bed rural hospital) operates a telemedicine-based antimicrobial stewardship program designed to improve prescribing of—and reduce bacterial resistance to—antibiotics, as required by California law. Key elements include ongoing monitoring of prescribing habits combined with various educational initiatives, including daily reviews of orders for certain classes of drugs, weekly infectious disease rounds, and periodic presentations and discussion at department meetings. All program elements are delivered via telemedicine by an offsite infectious disease specialist in collaboration with a hospital-based team of physicians, pharmacists, and other staff. The program has increased physician requests to have cultures analyzed and reduced their use of targeted classes of antibiotics, leading to less bacterial resistance to these drugs.

Evidence Rating (What is this?)

Moderate: The evidence consists of pre- and post-implementation comparisons of the number of cultures sent for identification of the underlying organism, annual hospital expenditures on two classes of antibiotics (with accompanying estimates of changes in use based on these data), and susceptibility of bacteria to the targeted drugs.