Antibiotic Stewardship Programs Reduce Hospital Readmissions

In hospitals with antibiotic stewardship programs dedicated to the appropriate use of antibiotic prescriptions, children are discharged sooner and are less likely to be readmitted, according to new research presented at IDWeek 2014.

Typically led by epidemiologists or infectious disease specialists, stewardship programs are designed to reduce antibiotic use and decrease the risk of antibiotic resistance in hospitalized patients.

In the 5-year study, researchers examined the antibiotic stewardship program at Children’s Mercy Hospital-Kansas City, which recommended discontinuing a prescribed antibiotic or changing the dosage or type of antibiotic in 17% of hospitalized children. Physicians could accept or reject the program’s recommendations, the most common of which was to discontinue an antibiotic deemed unnecessary.

Among hospitalized children without complex chronic care issues whose doctors accepted the program’s recommendations, the study authors found no 30-day readmissions. Conversely, 3.5% of study participants whose physicians rejected the recommendations were readmitted within 30 days.

Additionally, the length of stay averaged 68 hours when the program’s recommendations were followed, compared with an 82-hour average length of stay when they were not.

“Skeptics say stopping the antibiotics and sending the kids home sooner will lead to more children being readmitted, but we didn’t find that,” said lead study author Jason Newland, MD, medical director of patient safety and systems reliability for the hospital, in a press release. “What we found was that kids were being taken off unnecessary antibiotics sooner—and in a safe manner.”

According to previous research, up to 50% of antibiotics prescribed at hospitals are unnecessary or inappropriate, thus encouraging antibiotic-resistant infections.

“Studies have shown stewardship programs reduce antibiotic use and decrease the risk of antibiotic resistance, but this is the first to demonstrate that these programs actually reduce length of stay and readmission in children,” Dr. Newland said. “These findings reinforce the health benefits of antibiotic stewardship programs for some of our most vulnerable patients. It’s clear that more hospitals should invest their resources in implementing such programs.”