New research by the Centers for Disease Control and Prevention and Premier, Inc., concludes that the inappropriate use of antibiotics in U.S. hospitals could result in an estimated $163 million in excessive costs.
Beyond wasting hospitals’ precious financial resources, unnecessary antibiotics combinations increase the chances of adverse drug reactions in patients.
“Hospitals are constantly working on improving patient safety and efficiency in care processes,” said Leslie Schultz, lead author of the study and director of the Premier Safety Institute. “This study helps by adding a very clear and focused example of where they can target those efforts and safely reduce costs. There are always opportunities for improvement in all categories of antimicrobial use.”
Schultz said her team’s research should highlight and encourage “antimicrobial stewardship initiatives that the majority of U.S. hospitals already have in place today.”
The joint CDC-Premier study, “Economic Impact of Redundant Antimicrobial Therapy in U.S. Hospitals,” has been published in the October issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.
Researchers examined inpatient pharmacy data from more than 500 U.S. hospitals from 2008 to 2011 to determine possible inappropriate usage of 23 specific intravenous antimicrobial combinations. Nearly four out of five hospitals (78 percent) may have used unnecessary combinations of antibiotics for two or more days, the data analysis showed.
These potential cases of antibiotics misuse add up to nearly $13 million in estimated excess costs for the hospitals studied by the researchers. Extrapolating these numbers to all U.S. hospitals, the study team concluded that “appropriate prescribing” could save an estimated $163 million in costs.
That estimate doesn’t include costs for labor, supplies or patient treatment in the event of subsequent complications, so the savings from appropriate prescribing presumably would be higher.
Three specific drug combinations for treating anaerobic infections accounted for 70 percent of potentially inappropriate therapies, the study shows. And one combination in particular was responsible for more than half of the potential cases.
“The most frequent single and inappropriate combination -- metronidazole used with piperacillin-tazobactam -- should be considered the primary initial target for potential overuse,” Schultz said.
Drilling down into the antibiotics combinations detailed in the study should enable healthcare providers to “identify and root out unjustified variation or unnecessary redundant therapies,” Schultz said. “They can use this data to reduce costs and improve performance, patient safety, and outcomes.”
Schultz says that studies have shown that “comprehensive antimicrobial stewardship programs have consistently demonstrated a decrease in antimicrobial use with annual savings of $200,000 - $900,000.”
The CDC has created a “Checklist for Core Elements of Hospital Antibiotic Stewardship Programs” that can serve as a guide to healthcare providers for cutting unnecessary antibiotics costs.