Clinical Infectious Diseases Advance Access published October 28, 2013 1 Internet-based institutional antimicrobial stewardship program resources in leading US
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academic medical centers
Timothy P. Gauthier1,*, Evan Lantz2,**, Alexander Heyliger3, Sarah Francis4, Laura Smith5 1
Dept. of Pharmacy Practice, Nova Southeastern University College of Pharmacy; 3200 South
University Drive, Fort Lauderdale, Florida, 33328, USA
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Dept. of Pharmacy, Jackson Memorial Hospital; 1611 NW 12th Avenue, Miami, FL, USA
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Nova Southeastern University, College of Pharmacy; Fort Lauderdale, FL, USA
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Candidate; Nova Southeastern University, College of Pharmacy; Fort Lauderdale, FL, USA
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Dept. of Pharmacy, Jackson Memorial Hospital; Miami, FL, USA
Corresponding Author: Phone: (954) 262 – 1362; Fax: (305) 355 – 1529;
[email protected].
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Alternate Corresponding Author: Phone: (305) 585 – 8349; Fax: (305) 355 – 1529;
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[email protected].
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*
© The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e‐mail:
[email protected] Downloaded from http://cid.oxfordjournals.org/ at St. Petersburg State University on November 3, 2013
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1 Dear Editor, We read with great interest the article by Moodley et al [1], which presents a review of infectious
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diseases applications (apps) for the iPhone/iPad and Android devices. The authors detail numerous resources and discuss potential opportunities to optimize app reliability or
standardization, which is of value to a wide range of specialists. The purpose of this letter is to elaborate on the theme of accessible electronic resources by providing data on internet-based
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institutional antimicrobial stewardship program (ASP) web pages from leading American academic medical centers.
We utilized online search engines to analyze hospitals listed as University HealthSystem
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Consortium (UHC) members [2] to identify the existence of hospital and health-system ASP web pages. UHC is an alliance of hospitals representing the nation’s leading academic medical
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centers. Existence and components of institution-specific ASP online resources were recorded. To identify potentially prototypical formats, an internet site was considered “comprehensive” when a clear program description accompanied resources for at least three ASP elements or
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strategies per the Infectious Diseases Society of America and Society for Healthcare Epidemiology of America ASP guidelines [3]. Resulting data were evaluated and is presented using descriptive statistics.
The UHC member list produced 407 hospitals for evaluation. Of these, 24 (6%) were
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found to have online ASP resources through 18 unique websites. The Midwest and South US regions each account for a third of the websites. The median hospital size with an ASP website is just over 600 beds (range 25 to 1550 beds). Wexner Medical Center at The Ohio State
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University Medical Center incorporated password restriction and The University of Chicago Medicine utilized social media website Facebook® as a vehicle for their ASP website. A general program description and contact information is provided by 13 (73%) and 14 (78%) sites, respectively. A list of ASP members is available on 13 (73%) sites, with 15 (83%) sites disclosing both pharmacist and physician involvement. An antibiogram and external hyperlinks
2 related to antimicrobial use are provided by 11 (61%) and 10 (56%) sites, respectively. Fourteen (78%) websites note formulary restriction, of which three do not provide a list of
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restricted agents. Antimicrobial dosing recommendations and guidelines or clinical decision pathways are provided by 14 (78%) and 12 (67%) of sites. Four (22%) provided information as
one PDF document. Thirteen (72%) websites were determined to be comprehensive (Table 1). Publicly accessible web-based resources provided by ASPs of leading US hospitals
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exist in limited numbers and are primarily maintained by large institutions. Institution-specific characteristics and resources vary vastly, representing opportunity for standardization and
individualization. Institutional ASP websites may be a practical vehicle to provide accessible
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data to practitioners from numerous professions. Future research regarding the utility of these
(e.g., via apps) may be of value.
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Funding: none
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websites and initiatives to make institution-specific resources available on a mobile platform
Acknowledgments: none
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Conflicts of interest: none
3 References 1. Moodley A, Mangino JE, and Goff DA. Review of infectious diseases applications for
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iPhone/iPad and Android: from pocket to patient. Clin Infect Dis. 2013; 57(8): 1145-54. 2. University Healthcare Consortium. Https://www.uhc.edu/home.htm. Accessed 10 September 2013.
3. Dellit TH, Owens RC, McGowan JE, et al. Infectious diseases society of America and
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the society for healthcare epidemiology of America guidelines for developing an
institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007; 44:
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159-77.
Table 1. Webpages determined to be comprehensive Institution / Hospital
Hyperlink http://bugsanddrugs.stanford.edu
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Stanford Hospital & Clinics UCLA Health System (Ronald Reagan UCLA Medical Center)
http://www.asp.mednet.ucla.edu/pages/
http://ugotabug.med.miami.edu/jmh-antimicrobialstewardship-program/
University of Kentucky Hospital
http://www.hosp.uky.edu/pharmacy/amt/default.html
Barnes-Jewish Hospital
http://bjhtoolbook.wustl.edu/
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Jackson Health System (Jackson Memorial Hospital)
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http://www.wakehealth.edu/School/CAUSE/CAUSE. htm
Wake Forest Baptist Health
Maine Medical Center
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http://www.mainehealth.org/workfiles/mmc_em/Adul t_Antimicrobial_Formulary_Guide.pdf
Hospital)
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Johns Hopkins Health System (The Johns Hopkins
http://www.hopkinsmedicine.org/amp
NewYork-Presbyterian Hospital–Columbia University
http://www.cumc.columbia.edu/dept/id/clinical_refer
Medical Center
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The Nebraska Medical Center
http://www.nebraskamed.com/careers/educationprograms/asp http://www.clevelandclinicmeded.com/medicalpubs/ antimicrobial-guidelines/
Wexner Medical Center at The Ohio State University
http://rx.osumc.edu/asp/
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The Cleveland Clinic Foundation
University of Wisconsin Hospital and Clinics
http://www.uwhealth.org/antimicrobialstewardship/main/36408