Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug;55(4):220-223.
doi: 10.1177/0018578719844164. Epub 2019 May 4.

Anti-infective Waste in a Pediatric Institution: Pinpointing Problems in the Process

Christine E MacBrayne  1 , Manon C Williams  1   2 , Haley Obermeier  1   2 , Jason Child  1 , Justin W Heizer  1 , Matt Millard  1 , Kelly Pearce  1 , Casey Dugan  1 , Sarah K Parker  1   2
Affiliations

Anti-infective Waste in a Pediatric Institution: Pinpointing Problems in the Process

Christine E MacBrayne et al. Hosp Pharm. 2020 Aug.

Abstract

Purpose: At Children's Hospital Colorado (CHCO), there are approximately 40 000 inpatient anti-infective orders every year resulting over 100 000 dispenses. Significant quantities of anti-infectives are wasted, incurring roughly $100 000 in waste annually. Identifying areas for improvement will result in cost savings and ameliorate the impact of drug shortages. Summary: This descriptive report discusses the reasons for anti-infective waste at a free-standing, quaternary-care, pediatric hospital. The anti-infectives with the highest cost in waste ($) included meropenem ($38 084), micafungin ($21 690), amphotericin B liposome ($15 913). An internal audit of CHCO anti-infective waste revealed that drugs are wasted for the following reasons: patient discharge, medication order discontinuation or change, and misplaced doses. Conclusion: The CHCO Antimicrobial Stewardship Program and the Pharmacy have proposed 4 process improvement measures that will target anti-infective waste to reduce pharmaceutical waste and hospital costs. These measures may be applicable to other drug classes that likely suffer from a similar proportion of waste.

Keywords: anti-infective agents; anti-infective waste; antimicrobial stewardship; cost and cost analysis; pharmaceutical waste.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Anti-infectives with the highest number of wasted doses and highest waste in cost ($).
See this image and copyright information in PMC

References

    1. Sanchez GV, Fleming-Dutra KE, Roberts RM, Hicks LA. Core elements of outpatient antibiotic stewardship. MMWR Recomm Rep. 2016;65(RR-6):1-12. - PubMed
    1. Hurst AL, Child J, Pearce K, et al. Handshake Stewardship: a highly effective rounding-based antimicrobial optimization service. Pediatr Infect Dis J. 2016;35:1104-1110. - PubMed
    1. Nomura Y, Garcia M, Child J, et al. Effect of provider-selected order indications on appropriateness of antimicrobial orders in a pediatric hospital. Am J Health Syst Pharm. 2018;75:213-221. - PubMed
    1. Hurst AL, Child J, Parker SK. Intervention and acceptance rates support Handshake-Stewardship Strategy. J Pediatric Infect Dis Soc. 2018. (Epub ahead of print). - PubMed
    1. Parker SK, Hurst AL, Thurm C, et al. Anti-infective acquisition costs for a stewardship program: getting to the bottom line. Clin Infect Dis. 2017;65:1632-1637. - PubMed

LinkOut - more resources