Antibiogram software for long-term care pharmacy providers that build an F881 antibiogram for every client nursing home
Long-term care pharmacies sell stewardship programs to their client homes, and the antibiogram is the piece that eats consultant hours. Here is how pharmacy providers build one per home today, why thin isolate counts break the spreadsheet, and what a per-home tool costs.
8 min read
A long-term care pharmacy provider that builds antibiograms for its client nursing homes needs software that reads culture line lists from many labs, keeps the first isolate per resident, pools years and buildings when counts are thin, and prints one consistent report per home. Most providers do it today in Excel, one consultant pharmacist per building. Antimicrobe does it from a CSV upload, from $249 a month for one home and $2,400 a month for twelve.
This is written for the clinical services director, the stewardship lead or the consultant pharmacist at a long-term care pharmacy that serves dozens of skilled nursing facilities and owes each of them a stewardship program that survives an F881 survey. Pharmacy providers are described only from their own published pages.
What long-term care pharmacies already sell for antibiotic stewardship
Stewardship is now a standard part of the long-term care pharmacy offer. PharMerica publishes a model antibiotic stewardship program built on the CDC Core Elements, with prescribing protocols, timeout policies, a CDC core checklist for survey visits and infection management decision trees, and says the program is reviewed annually by an infectious disease specialist. Its page adds education, case consultations by consultant pharmacists, and help with monitoring antibiotic use, resistance and outcomes with regular reporting. Guardian Pharmacy lists antibiotic stewardship among the clinical services in its skilled nursing brochure.
Read those pages closely and the resistance side is the thinnest part. Protocols, binders and case reviews are pharmacist work the provider is built for. A facility antibiogram is a statistics job: a year or more of cultures from whichever lab each home uses, cleaned, de-duplicated and summarized by organism and drug. That job usually lands on the consultant who covers the building, in a spreadsheet nobody else can rerun.
Why the antibiogram is the hard part of the service
The counts are small and the labs are many. Fridkin and colleagues looked at urine cultures from 231 CMS-certified skilled nursing facilities in Georgia, all sent to one regional referral lab in 2016 and 2017 (Infection Control and Hospital Epidemiology, 2019, PMID 31133088). In one year, 49% of facilities had enough E. coli isolates for a facility antibiogram and only about 1 in 10 had enough Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis or Pseudomonas aeruginosa. Their conclusion was that aggregating across nursing homes in a region is a statistically sound fix.
A pharmacy provider is the one party that can actually do that aggregation, because it already serves many homes in the same region. The obstacle is mechanics. Each home sends cultures to a different lab, each lab exports in its own layout, and a consultant building 15 spreadsheets by hand cannot apply the same first isolate and 30 isolate rules to all of them every year.
How CLSI M39 treats repeat isolates, thin denominators and pooled years is laid out rule by rule on CLSI M39 antibiogram software.
Four ways pharmacy providers build client antibiograms
The lab printout is the quickest route and the least comparable one. A regional lab can often split its report by facility, which nursing home stewardship guides tell facilities to ask for, but each lab picks its own drugs, cutoffs and de-duplication, so two client homes ten miles apart can get reports that cannot be read side by side. WHONET and the AHRQ workbook apply the rules properly, and both reward a provider that has one trained analyst and the hours to rerun every home each year.
| Route | Who does the work | Same rules for every home | Pooling by region | Cost |
|---|---|---|---|---|
| Consultant spreadsheet per home | Each consultant pharmacist | Rarely | By hand | Consultant hours |
| Lab printout for the facility | The reference lab | Lab by lab | No | Usually included |
| WHONET or the AHRQ Excel workbook | A trained analyst | Yes, if configured | Yes, with work | Free, paid in staff hours |
| Antimicrobe | Anyone who can upload a CSV | Yes, by default | Yes, by facility column | From $249 a month |
How a pharmacy provider builds one antibiogram per client home
The workflow that scales is one file per lab, one facility column, one set of rules. Ask each lab that serves your client homes for a line list of every culture with susceptibility results over the period: a resident identifier (hashed is fine), collection date, facility, specimen source, organism, drug and the S, I or R the lab reported. Save each as CSV and upload them together.
Antimicrobe keeps the first isolate per resident per period, flags organisms under 30 isolates, pools years with the years printed, and filters by any column, so the same upload prints each home's own antibiogram and a pooled regional one for the homes in the same market. Every report carries a rule receipt with isolate counts before and after de-duplication, which is what a surveyor or a medical director asks for when a number looks odd.
The report has to be read to matter. Providers that run quarterly stewardship in-services for facility nurses often close them with a short check of what was learned, and auto-graded staff assessments make that a five-minute job across every client home instead of a stack of paper quizzes.
For a single building, the columns to request and a sample email to the lab are on nursing home antibiogram software. Homes on PointClickCare can see how the antibiogram sits beside the infection control module on PointClickCare antibiogram software.
Can a consultant pharmacist make an antibiogram for a nursing home?
Yes. A consultant pharmacist can build a nursing home antibiogram from the lab's culture line list, as long as the report follows CLSI M39: first isolate per resident per period, final results only, and no percent susceptible printed on fewer than 30 isolates. Most homes need two or three years pooled, labeled on the report, to reach that for anything beyond E. coli.
The harder question is whether the consultant should spend the hours. A consultant covering eight buildings who spends a day per building on the antibiogram has lost more than a week of drug regimen reviews to a statistics task a tool repeats in minutes.
How much does antibiogram software cost for a pharmacy provider?
Antimicrobe publishes every price. Lab is $249 a month for one facility, which suits a consultant pharmacist working for a single home. Stewardship is $749 a month for up to three facilities. Network is $2,400 a month for up to twelve facilities with cross-facility comparison, which works out to $200 per client home per month at full use. Enterprise is $3,990 a month with unlimited facilities and seats, for a provider serving a whole region. Annual billing is half the monthly price on every plan.
Enterprise surveillance platforms used by hospitals do not publish prices and are sized for acute care alerts and NHSN reporting, which a nursing home rarely buys from a separate vendor.
Every limit is on the pricing page, and the wider cost picture is in antibiogram software cost. Health systems pooling hospitals rather than nursing homes should read regional antibiogram software for health systems.
Questions to ask before you choose
- Which labs serve our client homes, and can each one send a culture line list instead of a PDF?
- Do all our client antibiograms apply the same first isolate and 30 isolate rules, and can we prove it?
- Which homes are in the same region and could share a pooled report?
- How many consultant hours a year go into building antibiograms today?
- Can the facility's director of nursing and medical director log in, or only our staff?
- Does the report print the rules it used, for the survey binder?
Related on this site: nursing home antibiogram software, PointClickCare antibiogram software, antibiotic stewardship software for nursing homes, CLSI M39 antibiogram software, Antimicrobe pricing.