2025 Southeastern Residency Conference

Title: Impact of a provider specific antimicrobial utilization report on prescribing practices at a community hospital


Authors: Maks Lutsenko, PharmD, Linda Johnson, PharmD, BCIDP


Objective: The goal of this project is to determine whether provider antimicrobial use "report cards" are effective at increasing the appropriateness of antimicrobial use.


Self Assessment Question: (True/False) Antimicrobial Stewardship programs are critical services that pharmacists can play key roles in reducing the overuse and misuse of antimicrobials?


Background: Antimicrobial stewardship is essential for ensuring the responsible use of antimicrobials in clinical practice to preserve their effectiveness and combat the rising threat of antimicrobial resistance. Antimicrobial stewardship programs aim to optimize the treatment of infections by promoting the appropriate selection, dosage, and duration of antimicrobial therapy, while also minimizing the overuse and misuse of these critical medications. Novel stewardship interventions, such as provider antimicrobial utilization “report cards”, have shown promise in modifying clinician behavior, yet their effectiveness in reducing unnecessary antimicrobial use is underexplored. Our institution created and distributed a provider specific antimicrobial use report to rounding hospitalists. The report had an “all antimicrobials” and a “piperacillin/tazobactam and cefepime” specific comparative de-identified bar graph and was paired with education. The goal of this project is to determine whether this intervention was effective at increasing the appropriateness of antimicrobial use.


Methods: Adult inpatients receiving antimicrobial therapy and being followed by a rounding hospitalist was included. Patients were excluded if being managed by the infectious diseases service or by a hematology/oncology provider. Primary endpoint will be antimicrobial use per provider in the pre-and post-periods (all antimicrobials and piperacillin/tazobactam/cefepime). Secondary endpoints will be collected from a subset of patients to evaluate the overall appropriateness of antimicrobial use. 


Results: For our primary endpoint, we found a statistically significant reduction in overall antimicrobial use, and also within the subgroup of piperacillin/tazobactam and cefepime. Regarding our secondary endpoints, we found numerical improvements in appropriate usage with regards to pneumonia and intra-abdominal infection patient subsets. No adverse safety outcomes were noted.


Conclusion: The provider specific antimicrobial utilization tool was effective at reducing overall antimicrobial use and specifically the use of piperacillin/tazobactam and cefepime.