1907. Surveillance of Emergency Department Antimicrobial Stewardship Practices in Sherwood Park, Alberta, Canada: a Closer Look at Respiratory Tract Infection Prescribing Patterns in Primary Care
Session: Poster Abstract Session: Antibiotic Stewardship: Outpatient and ED
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • STCH Poster Presentation v3.pdf (896.9 kB)
  • Background: Concerns exist regarding antimicrobial prescribing for respiratory tract infections (RTI) due to adverse reactions, avoidable drug costs, and the development of antimicrobial resistance. In RTI specifically, inappropriate antibiotic treatment of viral infections and guideline-concordant treatment of RTI remain areas of concern. The purpose of this investigation was to inform administration, prescribers, pharmacists and other allied health workers on the current state of antimicrobial prescribing surrounding RTI, and to measure the impact of regular reporting on patient outcomes and appropriate antimicrobial prescribing.

    Methods: A retrospective examination of adult patients who presented to the Strathcona Community Hospital emergency department (Sherwood Park, Alberta, Canada) between July and October 2015 with RTI symptoms (e.g. cough, sore throat, dyspnea). The primary outcome was treatment concordance to existing national and local practice guidelines (e.g. CHEST, Bugs and Drugs, Towards Optimized Practice). Secondary measures included reason(s) for non-concordance, diagnostics measured, and classes and volume of antimicrobials prescribed.

    Results: A total of 282 charts were reviewed, 142 of which were included in the analysis; 91 (64%) were female and the median age was 37 years (range 18-97 years). Overall concordance to guidelines was 86%, driven by appropriate viral illness treatment (symptomatic relief only). Twenty admissions (14%) resulted in an antimicrobial being dispensed, of which only 3 (15%) were concordant with guidelines. The most popular antimicrobials prescribed were azithromycin (30%) and amoxicillin (20%).

    Conclusion: There is sufficient practice of providing only symptomatic relief for viral RTI; however, there still exists a gap between ideal use of antimicrobials in respiratory infection and current practice.

    Rose Wang, BScPharm, University of Alberta, Faculty of Pharmacy and Pharmaceutical Services, Edmonton, AB, Canada, Micheal Guirguis, BScPharm, PhD, Alberta Health Services, Edmonton, AB, Canada and Daris Klemmer, BN, MN, NP-FAA, Alberta Health Services, Sherwood Park, AB, Canada

    Disclosures:

    R. Wang, None

    M. Guirguis, None

    D. Klemmer, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.