Impact of an Antimicrobial Stewardship Program Using Health Insurance Claim Database for Perioperative Antibiotic Monitoring at a Children's Hospital

Abstract

Monitoring perioperative antibiotic use by referring to each medical chart is time-consuming. Therefore, we developed a less labor-intensive method using the discontinuance rate of postoperative antibiotic from a health insurance claims database. We evaluated the pre- and postintervention impact using this method. All surgical operations and cardiac catheterization procedures involving perioperative antibiotic use were extracted from the health claims database. Standardization of perioperative antibiotics and their duration was introduced in April 2017. The pre- and postintervention periods were April 2014-March 2017 and October 2017-October 2021, respectively. The discontinuance rate of postoperative antibiotics on days 0 and 2 increased from 18.1% to 51.3% (p < 0.001) and from 63.5% to 80.3% (p < 0.001), respectively. Process metrics of perioperative antibiotic use calculated from the health claims database were easy to monitor and sustain our evaluation.