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International Journal of Clinical Pharmacy

, Volume 33, Issue 3, pp 521–528 | Cite as

Effects of an operational multidisciplinary team on hospital antibiotic use and cost in France: a cluster controlled trial

  • Sibylle Bevilacqua
  • Béatrice Demoré
  • Marie-Line Erpelding
  • Emmanuelle Boschetti
  • Thierry May
  • Isabelle May
  • Christian Rabaud
  • Nathalie Thilly
Research Article

Abstract

Objective The study objective was to evaluate the effectiveness of an operational multidisciplinary antibiotic team, including an infectious disease physician and a clinical pharmacist, in reducing the hospital antimicrobial consumption and costs. Setting The 1800-bed University Hospitals of Nancy (France). Method A cluster controlled ‘before-after’ study was performed. The intervention group comprised 11 medical and surgical wards in settings where the operational antibiotic team was implemented, and the control group comprised 6 wards without this operational team. The ‘before’ period (2005) preceded the implementation of the operational team in the intervention group and ‘after’ (July 2007 to June 2008) followed its full implementation. Main outcome measure We compared consumption of antibiotics overall and by therapeutic class (in defined daily doses per 1,000 patient days) and cost savings (in €) between ‘before’ and ‘after’ in both groups (control and intervention), using a mixed effect linear model. Results The overall consumption of antibiotics decreased after implementation of the operational team by 33.6% in the intervention group and by 3.3% in the control group (P = 0.003). Compared with the control group, the decrease in antibiotic use in the intervention group was significantly higher for various therapeutic classes (broad-spectrum penicillins, injectable fluoroquinolones, glycopeptides) and specific drugs (imipenem, ciprofloxacin, teicoplanin). For the same activity, the total cost savings were 14-fold higher in the intervention group. Conclusion Establishment of an operational multidisciplinary team may be an effective way to reduce hospital antibiotic use and cost, with a good acceptance rate among prescribers.

Keywords

Multidisciplinary team Antibiotics Consumption Costs Cost savings Cluster controlled trial France 

Notes

Acknowledgments

We would like to thank all clinicians of the University hospitals of Nancy, and particularly those of the Brabois hospital who welcomed us to their ward.

Funding

No funding was obtained for this study.

Conflicts of interest

None.

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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Sibylle Bevilacqua
    • 1
    • 2
  • Béatrice Demoré
    • 3
    • 4
  • Marie-Line Erpelding
    • 5
  • Emmanuelle Boschetti
    • 3
  • Thierry May
    • 1
    • 6
  • Isabelle May
    • 3
  • Christian Rabaud
    • 1
    • 6
  • Nathalie Thilly
    • 2
    • 5
  1. 1.Infectious and Tropical DiseasesUniversity Hospital of NancyNancyFrance
  2. 2.Nancy University, P. Verlaine—Metz University, Paris—Descartes UniversityNancyFrance
  3. 3.Pharmacy, Brabois HospitalUniversity Hospital of NancyNancyFrance
  4. 4.Laboratory of Clinical Pharmacy and Biotechnology, EA 3452Nancy UniversityNancyFrance
  5. 5.Department of Clinical Epidemiology and Evaluation, CIC-EC CIE6 InsermUniversity Hospital of Nancy, Brabois HospitalVandoeuvre lès NancyFrance
  6. 6.Host—Environment Relation, EA 4369Nancy UniversityNancyFrance

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