Hospital Antibiotic Prescribing Linked to MRSA Prevalence

October 23, 2020
Kevin Kunzmann

New data suggest collaboration between hospital prescribers and stewardship teams is still not perfected.

Investigators have observed an association between the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in higher hospital levels, and greater rates of antibiotic use, suggesting the need for improved anti-MRSA antibiotic prescribing benchmarks.

The data, presented at IDWeek 2020, showed that across 122 Veterans Health Administration (VHA) hospitals during 2016, median days of therapy (DOT) with anti-MRSA antibiotics 96.5 (IQR, 81.1 - 116.9) per 1000 days present, versus 562.1 (IQR, 505.9 - 631.6) DOT with total antibiotics per 1000 days present.

A hospital-level risk-adjusted analysis showed hospital MRSA prevalence was significantly associated with monthly anti-MRSA and total antibiotic prescribing (IRR, 1.05 and 1.02, respectively).

“A 5% increase in the hospital’s MRSA prevalence was associated with an increase in the monthly use of anti-MRSA antibiotics and total antibiotics by 23.6 and 8.3 DOT per 1,000 days-present, respectively,” investigators wrote.

In an interview with Contagion® during IDWeek, study author Daniel J. Livorsi, MD, MSc, Assistant Professor at the University of Iowa Carver College of Medicine, discussed his team’s findings and their implication for antibiotic stewardship needs.

“I think the other challenge is the way that stewardship teams generally interact with prescribers has changed as well,” he said. “We’re trying to discourage face-to-face conversations, and that’s often a good way to give feedback. If we’re trying to minimize doing that, we have to reconsider how we do stewardship.”

Watch the full interview with Livorsi in the video above.

The study, “Association of MRSA Prevalence and Hospital-level Antibiotic Use: A Retrospective Study Across 122 Acute-care Hospitals,” was presented at IDWeek 2020.