1004. Utilizing Procalcitonin Levels to Augment a Pharmacist Driven Antimicrobial Stewardship Program
Session: Poster Abstract Session: Stewardship: Implementing Programs
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • ID Week Poster Final.pdf (32.0 kB)
  • Background: Antibiotic overutilization remains a challenge for healthcare systems, with up to 50% of antibiotic use in the acute care setting being inappropriate. Procalcitonin (PCT) is a biomarker which has been used to evaluate the presence of bacterial infections. Using PCT levels has been shown to reduce the number of antibiotic prescriptions and reduce the duration of therapy for patients with suspected sepsis or lower respiratory tract infections (LRTIs). The objective of this study is to decrease antibiotic exposure in patients admitted with suspected sepsis and/or LRTIs through the addition of PCT levels to augment a pharmacist driven antimicrobial stewardship program.

    Methods: PCT algorithm recommendation forms were incorporated into the current antibiotic stewardship program at a 500-bed tertiary care community hospital. Provider education was delivered prior to the implementation of the chart notes and on an individual basis as needed. A daily report of PCT test results was used to identify patients in addition to the daily report of all patients on antibiotics. Patients identified by the antimicrobial stewardship team had a PCT algorithm form left in the chart with written recommendations for PCT levels and antibiotic regimen changes. Patients admitted to the medical floor from November 2012 – February 2013 with suspected sepsis and/or LRTI were eligible for inclusion. Antimicrobial utilization was calculated for each patient using days of therapy (DOT). The antimicrobial therapy cost was based on acquisition price and the cost for PCT was also included for the study group.

    Results: A total of 66 patients were included in the study and placed into either the PCT group (n=35) or the no PCT group (n=31). The utilization of PCT showed a four day reduction in the mean antibiotic days of therapy per patient (PCT 10.1 days vs. no PCT 14.4 days, p=0.002). There was no significant difference in the mean cost of treatment per patient in the PCT group compared to the no PCT group (PCT $178.74 vs. no PCT $209.11, p=0.54).

    Conclusion: The use of a PCT algorithm may help improve an antibiotic stewardship program through a reduction in antibiotic days of therapy without an increase in the average cost of treatment per patient.

    Jeff Brock, Pharm D. MBA1, Kelly Percival, Pharm D.1 and Aneesa Afroze, MD2, (1)Pharmacy, Mercy Medical Center, Des Moines, IA, (2)Chest, Infectious Diseases and Critical Care Associates, P.C., Clive, IA

    Disclosures:

    J. Brock, None

    K. Percival, None

    A. Afroze, None

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