A team approach to hospital formulary replacement.

A multidisciplinary antibiotic review team (MART) was implemented to improve patient care and reduce antimicrobial expenditures. MART consists of pharmacists and infectious disease (ID) physicians reviewing patients three times weekly. Antibiotic expenditures were reduced by recommending conversions to therapeutically equivalent antibiotics, conversion to an oral agent, and completion of treatment with home infusion therapy. In addition, MART proposed therapeutic interchanges from ceftriaxone to cefotaxime to the P and T committee. ID physician or pharmacist offered recommendations and initiated order changes if the attending physician agreed. Annualized savings was $74,371, with 40% of the recommendations resulting in an improved antimicrobial therapy.