Promotion of the Antimicrobial Stewardship Program in Our Hospital —Promotion of Correct Use of Anti–MRSA Agents through Multidisciplinary Conferences—

Abstract

  As a part of the antimicrobial stewardship program (ASP), our hospital has held regular “conferences for appropriate use of anti-methicillin-resistant Staphylococcus aureus (MRSA) agents” since 2006. The conferences include multiple disciplines including physicians, pharmacists, microbiological technicians, and nurses, and conduct evaluation of the status of use and feedback. All patients who receive anti–MRSA agents are evaluated. Based on the medical records and bacteriological test results, correct use is defined as “infection necessitating administration of anti–MRSA agents,” “high probability of such infection,” “administration necessary from clinical viewpoint,” and “febrile neutropenia.” In cases evaluated as “unevaluable” because no sample has been submitted for culture, or “administration not needed” because bacterial infection was considered to result from colonization or contamination, the purpose of administration was confirmed with the attending physician and intervention conducted if necessary. As indices for the efficacy of ASP, the trend of use of anti–MRSA agents and the trend of S. aureus sensitivity were investigated. As a result of active intervention, the number of cases of “correct use” in 2012 increased over that in 2006 (82.3% vs. 65.3%; p<0.01), although no marked changes in the number of patients using anti–MRSA agents and the trend of use were observed. Similarly, the rates of de-escalation therapy in 2012 increased over that in 2006 (85% vs. 33%; p<0.01). The rates of sensitivity of MRSA to vancomycin, teicoplanin, arbekacin, and linezolid were well maintained. This study indicates that holding multidisciplinary conferences and feedback of the evaluation results promote correct use of anti–MRSA agents and are effective in reducing the incidence of MRSA detection.