Appropriate Use of Meropenem: A Pharmacy Intervention

Abstract

Specific Aims: The primary objective was to determine the effectiveness of a criteria-based antibiotic order form (CBAOF) at increasing appropriate meropenem use at University of Arizona Medical Center –South Campus (UAMCSC). The secondary objective was to assess any cost savings associated with increased appropriate meropenem use. Methods: A retrospective chart review of patients (n = 133) meeting inclusion criteria at UAMCSC during the pre and post-intervention periods was conducted. Outcomes included appropriate empiric use of meropenem, appropriate treatment of a known pathogen use of meropenem, appropriate dose and frequency of meropenem, appropriate antibiotic streamlining after culture and susceptibility report, and meropenem acquisition costs. Main Results: Appropriate empiric use of meropenem was significantly higher after the implementation of the CBAOF (100% vs. 65.8%, p = 0.002). Although not statistically significant, the post-intervention group had more patients meeting the criteria for appropriate use of meropenem for a known pathogen than the pre-intervention group (50% vs. 40%, p = 0.809). There were no differences between the pre and post-intervention groups with respect to appropriate dose of meropenem or appropriate frequency. After the implementation of the CBAOF there were significantly more patients who received antibiotic streamlining within 24 hours of culture and susceptibility reports (12.5% vs. 48.7%, p = 0.002). Drug acquisition costs for meropenem were reduced by approximately $30,000 after CBAOF implementation. Conclusion: The CBAOF was effective at increasing appropriate empiric meropenem use and decreasing meropenem acquisition costs at UAMCSC.