Physicians with hospital privledges are told to pay attention to the antibiograms produced by the hospital's clinical laboratory. These are the reports on community resistance to various antibiotics, which is important to note for the clinician because it will often portend success or failure in treatment. If the patient is sick enough, such decisions may have serious consequences for the patient if the wrong antibiotic is chosen.
Below is an example assessment utilizing forecast algorithms for antimicrobial resistance based on a real world local hospital. Several factors were noted in this assessment:
- Healthcare provider prescribing behavior that is predicated on experience. The inherent risks of such prescribing behavior were believed to be greater if the provider was a locum tenens (i.e. a provider moving between hospitals in different states or localities). The implication was that such providers tended to rely on the Sanford Guide as opposed to local antibiograms.
- That, as taught in medical school (yet typically ignored by providers), local antibiograms trump general guides such as Sanford.
- That no medical institution to our knowledge routinely uses forecasts of antimicrobial resistance to guide antimicrobial resistance stewardship program implementation. It is our experience that forecasts provide additional locale-specific information beyond what the retrospective antibiograms provide.
The dependencies in prescriber behavior follow the points above, such that if prescribers are not using a "local medical intelligence"-informed approach that 1) includes a locality's antibiogram coupled to 2) a locality's forecasted antimicrobial resistance patterns, then antimicrobial stewardship may fall short. And patient care outcomes may not be optimized.