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Critical Care Research and Practice
Volume 2014 (2014), Article ID 307817, 4 pages
http://dx.doi.org/10.1155/2014/307817
Research Article

Influence of an Infectious Diseases Specialist on ICU Multidisciplinary Rounds

Department of Medical Education, Providence Portland Medical Center, 5050 NE Hoyt, Suite 540, Portland, OR 97213, USA

Received 20 February 2014; Revised 2 April 2014; Accepted 3 April 2014; Published 17 April 2014

Academic Editor: Gilles L. Fraser

Copyright © 2014 David N. Gilbert. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To ascertain the influence of a physician infectious diseases specialist (IDS) on antibiotic use in a medical/surgical intensive care unit. Method. Over a 5-month period, the antibiotic regimens ordered by the ICU multidisciplinary team were studied. The days of antibiotic therapy (DOT) when management decisions included an IDS were compared to DOT in the absence of an IDS. The associated treatment expense was calculated. Results. Prior to multidisciplinary rounds (MDRs), 79-80% of the patients were receiving one or more antibiotic. IDS participation occurred in 61 multidisciplinary rounding sessions. There were 384 patients who before MDRs had orders for 669 days of antimicrobial therapy (DOT). After MDRs, the antimicrobial DOT were reduced to 511 with a concomitant cost saving of $3772. There were 51 MDR sessions that occurred in the absence of the IDS. There were 352 patients who before MDRs had orders for 593 DOT. After MDRs, the DOT were reduced to 572 with a cost savings of $727. The results were normalized by number of patients evaluated with statistically greater reductions when MDRs included the IDS. In addition, the number of rounding sessions with a reduction in DOT was greater with the participation of the IDS. Conclusion. The addition of an IDS to multidisciplinary ICU patient rounds resulted in a reduction in antibiotic DOT and attendant drug expense.