Action by Infection Control Team to Ensure Proper Usage of Anti-MRSA Medicines in Showa University Fujigaoka Hospital

Abstract

The infection control team at Showa University Fujigaoka Hospital placed a formulary restriction on physicians’use of anti-methicillin resistant Staphylococcus aureus (MRSA) agents (vancomycin,arbekacin and teicoplanin) in January 2004.To evaluate the effect of this restriction,we investigated the changes in numbers of vials of anti-MRSA agents used between 1 year before and 1 year after the restriction was implemented,and in the numbers of new MRSA-positive inpatients (newly registered inpatients with MRSA infection or contamination).
There was a significant decrease in monthly vial consumption for intravenous (iv) and oral vancomycins.This was accompanied by a 66% decrease in the cost of vancomycins used.However,there was no increase in the number of newly registered MRSA-positive inpatients over this period.There was also no significant change in monthly vial consumption for the newer anti-MRSA agents,arbekacin and teicoplanin,which was because the number of prescriptions of these drugs was much smaller than that for vancomycins.
By hospital department,there was a remarkable decrease in iv and oral vancomycin usage in Gastroenterology and in the use of iv vancomycins in Chest Surgery.However,there was no significant decrease in newly registered MRSA-positive patients in these 2 departments.
These findings suggest that such a formulary restriction contributes to ensuring the proper usage of anti-MRSA agents for inpatients with MRSA infections as well as to reducing medical costs.