Program Schedule

209
Results of an Antimicrobial Stewardship Intervention Involving Surgical Subspecialty Patients

Session: Poster Abstract Session: Antibiotic Stewardship
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • 209_IDWPOSTER.pdf (307.0 kB)
  • Background: Antimicrobial stewardship can improve antimicrobial use and clinical outcomes in hospitalized patients. A core antimicrobial stewardship strategy is prospective case review with real-time recommendations to prescribers; however, the impact of this intervention has not been described for surgical patients. With multi-disciplinary involvement, the antimicrobial stewardship team developed a prospective review and feedback intervention for surgical subspecialty patients.

    Methods: Beginning in November 2013, an Infectious Diseases Clinical Pharmacist performed three-times-weekly prospective case review for all inpatients receiving antibiotics, other than peri-operative prophylaxis, on the following surgical services: Neurosurgery, Maxillofacial Surgery, Plastic Surgery, Otolaryngology, and Urology. When appropriate, recommendations regarding antibiotic utilization were communicated to the surgical teams. A summary of the interventions and acceptance rate over the initial 5-month period is summarized.

    Results: A total of 65 patients were reviewed during the study period on the surgical services: Neurosurgery (n=29, 45%), Maxillofacial Surgery (n=10, 15%), Plastic Surgery (n=8, 12%), Otolaryngology (n=1, 1.5%), and Urology (n=17, 26%). A total of 29 prescribing recommendations were made in those 65 patients (44% of cases reviewed). Recommendations made per surgical service include Neurosurgery (n=15, 52%), Maxillofacial Surgery (n=1, 3%), Plastic Surgery (n=4, 14%), Otolaryngology (n=1, 3%), and Urology (n=8, 28%). The most common recommendations made were de-escalation of therapy (n=10, 15%), antibiotic discontinuation (n=6, 9%), and duration of therapy (n=4, 6%). Of the recommendations made, 23 were accepted by the surgical services (79% acceptance rate).

    Conclusion: A multi-disciplinary antimicrobial stewardship collaboration performing prospective case review in a surgical subspecialty population led to opportunities to improve antibiotic use in nearly half of cases with high rates of recommendation acceptance. Further evaluations should incorporate evaluating the impact of overall antimicrobial use and clinical outcomes.

    Kati Shihadeh, PharmD1,2, Michelle Haas, MD3,4, Philip Mehler, MD5, Marcia Eustaquio, MD6 and Timothy Jenkins, MD3,4, (1)University of Colorado Skagg’s School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, (2)Acute Care Pharmacy, Denver Health Medical Center, Denver, CO, (3)Medicine/Infectious Diseases, Denver Health Medical Center, Denver, CO, (4)Medicine/Infectious Diseases, University of Colorado-Denver Health Sciences Center, Denver, CO, (5)Denver Health Medical Center, Denver, CO, (6)Otolaryngology - Head and Neck Surgery, Denver Health Medical Center, Denver, CO

    Disclosures:

    K. Shihadeh, None

    M. Haas, None

    P. Mehler, None

    M. Eustaquio, None

    T. Jenkins, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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