1045. Effect of Implementing a Community Acquired Pneumonia (CAP) Order Set on Fluoroquinolone Use
Session: Poster Abstract Session: Stewardship: Improving Treatments
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
  • Effect of implementing a CAP order set on FQ use JR 1045.pdf (844.9 kB)
  • Background: Implementation of evidence-based community-acquired pneumonia (CAP) order sets decrease in-hospital and 30 day post-admission mortality. While fluoroquinolones are a first-line treatment option for inpatient CAP, their use is often inappropriate and is associated with the development of drug resistant infections, including Clostridium difficile associated diarrhea. For this reason, Charleston Area Medical Center implemented a new CAP order-set that de-emphasizes fluoroquinolones by recommending as a second-line treatment option.

    Methods: The objective of this study was to determine the effect of a CAP  order-set on the frequency of fluoroquinolone prescribing. Our study was a retrospective cohort comparing rates of fluoroquinolone use between patients admitted before and after new CAP order-set implementation. Patients were included in the study if they had a diagnosis of pneumonia as classified by ICD-9 codes from January 1, 2010 until December 31, 2011. Patients were excluded if they met any criteria for health-care associated pneumonia or if they were admitted after order set implementation without being treated with the CAP order set. The primary outcome of the study was the change in the rate of fluoroquinolone use after order set implementation.

    Results: A total of 168 patients were included in the study. A significant difference was found in rates of fluoroquinolone use between groups (67.6% before implementation vs 27.0% after implementation; P <0.001). There was no difference in length of stay between groups.

    Conclusion: Implementation of a new community acquired pneumonia set significantly decreased the use of fluoroquinolones within our institution. This study demonstrates that simple interventions are able to have a large impact on prescribing patterns.

    Rachel Dispennette, PharmD1 and Jessica Robinson, PharmD, BCPS1,2, (1)Charleston Area Medical Center, Charleston, WV, (2)University of Charleston School of Pharmacy, Charleston, WV


    R. Dispennette, None

    J. Robinson, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.