While hospitals in the U.S. were found to vary in their policies and practices of surveillance, decolonization, and treatment of methicillin-resistant Staphylococcus aureus infections, most were found to be consistent with national guideline recommendations, according to researchers at the University of Illinois at Chicago.
The researches used a 61-item questionnaire sent to the directors of pharmacy at 263 acute care hospitals that were members of a national group purchasing organization. Responses were received from 102 hospitals (38.8%). Active surveillance culture protocols were found to be in place at 44 of those hospitals (44%), and MRSA decolonization policies were found in approximately 25% of the respondent hospitals.
Vancomycin was reported as the most commonly used antimicrobial in those hospitals for the treatment of various MRSA infections, followed by linezolid. Vancomycin was on the formulary in all hospitals with few restriction policies, while the newer anti-MRSA agents—linezolid, daptomycin, and tigecyclin—were on the formulary in most hospitals, but with restrictions.
About 70% of the responding hospitals reported having a vancomycin-specific dosing or monitoring guidelines in place. The use of actual body weight was specified for dosing and therapeutic monitoring of serum concentrations at 84% and 91% of the hospitals respectively.
Nearly 75% of the responding hospitals said they engaged in key antimicrobial stewardship activities, while just 18% reported having a formal antimicrobial stewardship team, according to the study, which appears in the American Journal of Health-System Pharmacy.
Nearly all of the hospitals surveyed said they had adopted hand-hygiene practices. Other preventive practices include the use of gowns and gloves and isolation of MRSA-positive patients, said Yoojung Yang, a fellow in the Center for Pharmacoeconomic Research who led the study.
"The results of our survey suggest that pharmacists play a key role in the treatment of MRSA infections," Yang says. Nearly 75% of the responding hospitals said they reviewed antimicrobial prescription orders and placed restrictions on the use of select antimicrobials in an effort to ensure optimal use of the drugs and to reduce the risk of bacterial resistance.
See also:
Pages
Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.