MRSA policies differ among hospitals, study says

Hospitals differin how they detect and treat drug-resistant staph infections, but most follow national guideline recommendations, according to researchers at the University of Illinois at Chicago.

Pharmacy directors at 102 acute-care hospitals in the United States were surveyed about their policies and practices regarding methicillin-resistant Staphylococcus aureus, or MRSA. All of the hospitals are members of Broadlane, a Dallas-based healthcare cost management company.

Among the hospitals that responded, 43 percent said they had a procedure to screen patients for MRSA, a strain of staph bacteria that has become resistant to antibiotics commonly used to treat ordinary staph infections, said Yoojung Yang, a fellow in the Center for Pharmacoeconomic Research, who led the study.

MRSA is a leading cause of costly healthcare-acquired infections in hospitals or other healthcare settings, such as nursing homes and dialysis centers.

Nearly all of the hospitals surveyed have adopted hand-hygiene practices, Yang said. Other preventive practices include the use of gowns and gloves and isolation of MRSA-positive patients, she said.

Nearly 75 percent of the responding hospitals review antimicrobial prescription orders and place restrictions on the use of select antimicrobials to ensure optimal use of the drugs and reduce the risk of bacterial resistance, Yang added.

"The results of our survey suggest that pharmacists play a key role in the treatment of MRSA infections because they have the knowledge of how best antimicrobials can be used," she said.

Vancomycin, the traditional drug of choice, was on the formulary in all of the hospitals, and only three had restrictions placed on its use, the study showed. Newer drugs such as linezolid, daptomycin and tigecycline were on the formulary in many hospitals. Restrictions on their use were reported by more than half.

According to Glen Schumock, professor and director of the Center for Pharmacoeconomic Research and a study assistant, this is the first survey of hospital pharmacy directors to address comprehensive MRSA treatment options. The results, he said, could identify areas for potential improvement in the prevention and management of the potentially deadly pathogen.

The study, funded by a grant from the Agency for Healthcare Research and Quality, was printed in the American Journal of Health-System Pharmacist.

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