Improving the Use of Antimicrobials to Treat Gram-Positive Infections: Encouraging Appropriate Use and Minimizing Antimicrobial Resistance

Under the auspices of the MGH Antimicrobial Stewardship Program (ASP), this inpatient-based quality improvement initiative will target inappropriate prescribing of daptomycin and linezolid, two powerful antibiotics increasingly used in the inpatient setting. Specifically, a multidisciplinary team will identify current inpatients receiving greater than 72 hours of treatment with daptomycin or linezolid and assess treatment appropriateness; for cases without microbiological data supporting continued use of these antibiotics, clinicians will receive targeted, evidence-based educational feedback about de-escalation strategies. The primary goal of reducing inappropriate prescribing of daptomycin and linezolid will be measured by comparing days of therapy (DOT) / 1000 patient days pre- and post- intervention. In parallel, a case-based clinician education program will be developed and deployed, with impact of both interventions measured through pre- and post-surveys of clinicians.