Implementation of a diuretic stewardship program in a pediatric cardiovascular intensive care unit to reduce medication expenditures

• DOI: 10.2146/ajhp140532
• Publication Date: 2015-05-29T19:08:19Z
• Authors: Christopher A. Th...; Jennifer L. Morris; Elizabeth A. Sinc...; Richard H. Speicher; Sheikh S. Ahmed; Alexandre T. Rotta
• Keywords: Chlorothiazide; Stewardship; Loop diuretic

The implementation of a diuretic stewardship program in pediatric cardiovascular intensive care unit (ICU) is described.This retrospective study compared the use i.v. chlorothiazide and ethacrynic acid surgery patients before after program. All admitted to service were included. was educated on formal indications for specific agents, implemented January 1, 2013. Under program, indicated with sulfonamide allergy, considered appropriate receiving maximized loop doses. A detailed review pharmacy database medical records performed each patient determine expenditures, appropriateness use, days using ventilator, ICU length stay.After stewardship, decreased by 74% (531 fewer doses) while 92% (47 doses), resulting total reduction $91,398 expenditures these diuretics over six-month period an estimated annual saving $182,000. median number ventilator stay did not differ significantly during period.Implementation reduced without adversely affecting clinical outcomes such as ICU.