A RANDOMIZED, PROSPECTIVE EVALUATION OF AN INTERVENTIONAL PROGRAM TO DISCONTINUE INTRAVENOUS ANTIBIOTICS AT 2 TERTIARY CARE TEACHING INSTITUTIONS

To evaluate a program to discontinue intravenous antibiotics at two te aching hospitals, 102 inpatients meeting eligibility criteria were ran domly assigned to two groups. In one group, patients' physicians were contacted by pharmacists with recommendations to discontinue intraveno us antibiotic therapy; in the other, patients were simply observed. Me asured outcomes were antibiotic costs, length of stay, need to restart intravenous;antibiotics, in-hospital mortality, and 30-day readmissio ns. The intervention significantly reduced mean antibiotic costs per p atient ($19.82 vs $35.84, p=0.03), but related labor costs exceeded th is benefit. Readmissions were significantly more frequent in the inter vention group than in the control group (29% vs 9.8% p=0.02), but they were not infection related. No impact was demonstrated on the other m easured outcomes. Institutions considering such programs or with one i n place should conduct similar evaluations.