Impact of Infectious Diseases Team Consultation on Antimicrobial Use, Length of Stay and Mortality

Background: Infectious disease (ID) clinicians and multidisciplinary teams may have a beneficial impact on patient outcomes. This study was conducted to determine the impact of dedicated ID team rounding in an adult noncardiac intensive care unit (ICU) on antimicrobial costs, length of stay and mortality. Methods: The authors instituted dedicated ICU ID team rounds at a large tertiary care hospital ICU ("intervention"), with the ID team conducting rounds in the ICU every weekday. The authors compared the cost of antimicrobial agents, total hospital and ICU length of stay and inpatient mortality for the 6-month period before and after institution of these rounds between those seen versus those not seen by the ID team. Results: Among 386 patients analyzed, 206 were admitted in the preintervention and 180 in the postintervention period. Among those seen by the ID team, there was an 18% decrease in total antimicrobial cost (P < 0.0001), 40% decrease in ICU length of stay (P = 0.1), 33% decrease in overall hospital length of stay (P = 0.03) and 34% decrease in mortality (0.04) from preintervention to postintervention period. Among those not seen by ID, there was a 39% decrease in cost among those not seen by ID (P < 0.0001), but length of ICU or hospital stay and mortality were not significantly different. Conclusions: Institution of dedicated ID team rounding in the ICU leads to substantial decreases in antimicrobial costs, hospital length of stay and inpatient mortality among those patients seen by the team.