US hospital pharmacy and therapeutics committees decision-making process for antibiotics and antifungal therapies

In addition to managing the hospital’s anti-infective formulary, hospital pharmacy and therapeutics (P&T) committees in the USA most frequently cite management of issues related to antibiotic resistance, drug cost/cost effectiveness and appropriate antibiotic selection/use, according to a new study from Arlington Medical Resources (AMR) based on 105 hospitals.

One mechanism hospitals are using to manage antibiotic use is antimicrobial stewardship programs; nearly three-quarters of hospitals in this study have an established, formal antimicrobial stewardship program.

P&T committees report ongoing efforts to minimize the number of therapeutically equivalent products on formulary. Data from this study show that although ertapenem (Merck & Co’s Invanz), meropenem (AstraZeneca’s Merrem, generics), and imipenem-cilastatin (Merck’s Primaxin) have near equal high rates of hospital formulary inclusion and formulary uptake of doripenem (Johnson & Johnson’s Doribax) has rapidly climbed over the last five years, the perceived therapeutic equivalence of carbapenems is leading P&T committees to limit the number of carbapenems on formulary.