Study: Electronic checklists can reduce unnecessary antibiotic use

“Time-out” audits using structured electronic checklists can help put a dent in unnecessary or inappropriate antibiotic use while reducing costs, according to a study published in the Annals of Internal Medicine.

In the study, clinicians at Montreal General Hospital received monthly education on antimicrobial stewardship and resident physicians adjusted patients’ antibiotic therapy through twice-weekly time-out audits utilizing the checklists. Over a period of 18 months, 679 patients were evaluated.

The researchers standardized and compared antiobiotic costs in the year before and after the audits. Total antibiotic use and the use of moxifloxacin, carbapenems, antipseudomonal penicillins and vancomycin were compared by using interrupted time series. Rates of nosocomial Clostridium difficile infection were compared by using incidence rate ratios, according to the study.

The intervention decreased costs from $149,734 (January 2011-January 2012) to $80,319 (January 2012 to January 2013) for a total savings of $69,424. Seventy eight percent of the savings was related to carbapenems and 22 percent was due to other antibiotic classes. Also, rates of C. difficile infection decreased from 24.2 to 19.6 per 10,000 patient days.

“An antibiotic self-stewardship bundle to implement ... time-outs seems to have reduced overall costs and targeted antibiotic use,” concluded the authors.