Impact of tele-antimicrobial stewardship at two small community hospitals in partnership with an academic medical center: two years of experience.

Objective: To analyze the impact of a fully remote tele-antimicrobial stewardship program (TASP) at two small community hospitals in partnership with an academic medical center. Design: Retrospective survey from August 1, 2020, to July 31, 2022. Setting: A TASP, co-led by an infectious diseases (ID) physician and ID pharmacist, was implemented at M Health Fairview (MHF) Northland, a 21-bed hospital, and at MHF Lakes, a 49-bed hospital. The ID physician and ID pharmacist are located at the University of Minnesota Medical Center. Methods: Antimicrobial stewardship interventions were tracked monthly. Restricted antimicrobial days of therapy per 1000 patient days (DOT/1000 PD) were also tracked monthly and two years pre and postimplementation data were compared. All annual antimicrobial expenditures were followed. Results: For the first two TASP years, a total of 789 antimicrobial interventions were made with 85.6% being accepted. Restricted antimicrobial use trended down from 142.93 to 113.97 DOT/1000 PD at MHF Northland. A smaller decrease from 106.31 to 103.12 DOT/1000 PD was seen at MHF Lakes. Annual antimicrobial costs per total patient days decreased. MHF Northland hospital's annual antimicrobial expenditures per total patient days fell from $18.89 in 2019 (preimplementation) to $6.64. MHF Lakes followed a similar trend, decreasing from $11.20 to $5.36. Conclusions: A fully remote TASP in partnership with an academic medical center for two small community hospitals resulted in high rates of accepted interventions sustained over two years. Restricted antimicrobial use and antimicrobial costs trended down.