Antimicrobial Stewardship Program in an acute care hospital in New Orleans: impact on antibiotic utilization

Abstract Objectives: To evaluate antibiotic utilization in relation to antimicrobial stewardship activities in a 170-bed Touro Infirmary hospital in New Orleans. Methods: We evaluated antibiotic utilization for antipseudomonal beta-lactams, methicillin-resistant Staphylococcus aureus antibiotics (anti-MRSA), fluoroquinolones, and ceftriaxone in relation to antimicrobial stewardship activities that were implemented at the hospital and monitored between August 1, 2018, and August 31, 2025. We recorded days of antibiotic therapy and days of intravenous antibiotic administration for 19-months baseline, during 10 months of COVID-19-dictated antibiotic utilization, and during 14 months of MRSA PCR testing at Touro (Antimicrobial Stewardship Intervention [ASI] 1), 20 months of blood culture identification (BCID) at Touro (ASI 2, time 1), followed by 22 months of BCID and other cultures sent out to University Medical Center (ASI 2, time 2). Results: During the observation period, days of therapy for antipseudomonal beta-lactams, anti-MRSA, and fluoroquinolones consistently and significantly decreased from baseline to ASI 2, time 2 ( P < .0001 for each decrease). Days of therapy for ceftriaxone significantly increased from ASI 1 to ASI 2, time 2 ( P < .0001). Days of therapy for all antibiotics consistently decreased from baseline to ASI 2, time 1 ( P < .0001) but not through time 2 ( P = .571). Days of intravenous administration of antibiotics significantly decreased from baseline to the COVID-19 period ( P = .002) and decreased again significantly from ASI 1 to ASI 2, time 1 ( P = .003). Conclusions: Clinical microbiology laboratories integrated into Antimicrobial Stewardship Program are associated with reductions in days of antibiotic therapy and days of intravenous antibiotic administration at Touro Infirmary.