Culture and antibiotic monitoring service in a community hospital.

A culture-antibiotic monitoring service (CAMS) established by the pharmacy in a 254-bed community hospital is described. CAMS was offered as a clinical pharmacy consultation service to reduce the delay between availability of culture-report results in the laboratory and evaluation of these results by the physician. The pharmacist reviews culture results in conjunction with the patient's antibiotic therapy and clinical condition and contacts the physician regarding changes in therapy according to predetermined criteria. The pharmacist is also able to promote appropriate antibiotic prescribing and generate cost savings through interactions with physicians facilitated by CAMS. More than 98% of physicians agreed to participate in CAMS. During a one-year period, physicians implemented 87.1% of pharmacist-recommended changes in antibiotic therapy in 202 patients. The projected cost savings through a reduction in inappropriate prescribing of ceftazidime alone during a 10-month period enabled the pharmacy to easily justify hiring an additional clinical pharmacist. The culture-antibiotic monitoring service has enabled the pharmacy department to foster appropriate use of antibiotics and to realize substantial cost savings.