Purpose: Overview of implemented antimicrobial stewardship by ERASE C. difficile participants. Describes examples of antimicrobial stewardship interventions implemented by six participating facilities in ERASE C. difficile Project, including details of activities, timeframes, locations, and stewardship staffing or activities.
Source: Adapted from ERASE C. difficile Project by H. Jalon, United Hospital Fund, and B. Ostrowsky, Montefiore Medical Center.
| Facility Description | Interventions | Start Date | Location | Notes/Comments |
|---|---|---|---|---|
| 481-bed teaching hospital | Specific programming of antibiotic stewardship computer software to identify patients with longer antibiotic lengths (>14 days) | Approximately 1 year | Hospitalwide |
|
| Clinical computer prompts IV to oral switch (asks for indication) | July 2011 | Hospitalwide | ||
| Antibiotic change policy away from ciprofloxacin for urinary tract infections | September-November 2011 | ER(ED), then hospitalwide | ||
| December 2011-January 2012 | ||||
| 863-bed teaching hospital | Piperacillin/tazobactam restriction | August 2010 | Hospitalwide |
|
| Audit and feedback | Ongoing (predates ERASE C. difficile Project) |
Hospitalwide | ||
| 709-bed teaching hospital, with two sites (each similar size): Activities at Site 1 | Piperacillin/tazobactam restriction (many years old) | Ongoing (predates ERASE C. difficile Project) |
Hospitalwide |
|
| Audit and feedback (de-escalation; emphasis on cefepime) | Ongoing July-September 2011 |
Hospitalwide | ||
| Ongoing October 2011-present |
||||
| 709-bed teaching hospital, with two sites (each similar size): Activities at Site 2 | Piperacillin/tazobactam restriction (many years old) | Ongoing (predates ERASE C. difficile Project) |
Hospitalwide | |
| Audit and feedback (de-escalation; emphasis on cefepime) | Ongoing July-September 2011 |
Hospitalwide | ||
| Ongoing October 2011-present |
||||
| Algorithms/education targeting efepime use specifically in ICU | January 2011 | MICU (7EM Medical) | ||
| 1,038-bed teaching hospital, with two sites: Activities at Site 1, approximately 700 beds | Azithromycin restriction | April-May 2011 | Hospitalwide |
|
| Piperacillin/tazobactam audit and feedback Educational component |
Pilot (with infectious disease fellow): February-April 2011 Increased activity (restructuring with clinical pharmacists): May-October 2011 |
Medicine (Teaching and PA) Klau and NW |
||
| Sepsis antibiotic protocols | May 2011 | ER(ED); reflected in hospitalwide prescribing | ||
| 1,038-bed teaching hospital, with two sites: Activities at Site 2, approximately 300-400 beds | Azithromycin restriction | April-May 2011 | Hospitalwide | |
| Piperacillin/tazobactam audit and feedback Educational component |
Pilot (with infectious disease fellow): February-April 2011 Increased activity (restructuring with clinical pharmacists): May-October 2011 |
Medicine (Teaching and PA) |
Instructions: Use as a reference.
