Controlling antimicrobial costs has preoccupied infectious diseases physicians (IDPs).
IDPs have controlled antimicrobial costs by the use of eight strategies : education, formulary restriction, pharmacy justification, formulary substitution, computer surveillance, laboratory item cost listing, purchase plans, and multidisciplinary approaches.
Most strategies had input from IDPs and resulted in cost savings (up to $500,000 annually), particularly during the initiation periods.
Educational efforts were successful in reducing costs but needed continual intervention.
Formulary restriction was the most straightforward cost-control mechanism.
Restriction of « target antimicrobials » has given way to « switch » therapy between expensive and less costly agents or between parenteral and oral regimens.
Switch therapy is facilitated through the use of innovative order forms and on-line computer interaction.
Computer surveillance has a capacity for interactive controls.
Purchase plans may give way to centralized pharmacy monitoring, a strategy that is attractive to managed care organizations.
Multidisciplinary antimicrobial management programs (AMPs) offer the best potential for sustaining savings in antimicrobial costs.
Ten recommendations lay a groundwork for IDPs to translate their expertise into leadership of AMPs.
Mots-clés Pascal : Infection, Coût, Aspect économique, Traitement, Education, Médecin, Antimicrobien, Hôpital, Economie santé
Mots-clés Pascal anglais : Infection, Costs, Economic aspect, Treatment, Education, Physician, Antimicrobial agent, Hospital, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0239669
Code Inist : 002B05A02. Création : 11/06/1997.