978. Leveraging Online Curricula for Antimicrobial Stewardship: Training Providers to Optimize Therapy with Antibiotic Timeouts
Session: Poster Abstract Session: Antibiotic Stewardship: General Acute Care Implementation and Outcomes
Friday, October 28, 2016
Room: Poster Hall
Posters
  • ATOCME_IDWEEK2016.pdf (3.1 MB)
  • Background:  The CDC promotes an Antibiotic Timeout as a one measure to improve antimicrobial use.  While the concept of an antibiotic timeout may be simple, its implementation often proves difficult in practice.    

    Methods:  We developed a free, 2-hour online course that targets primary prescribers and is both CME and CPE certified.   Optimizing Antimicrobial Therapy with Timeouts is based upon 5 inpatient cases with embedded multiple-choice questions and 5 short didactic presentations.  The cases describe common scenarios encountered in adult hospitals:  community-acquired pneumonia, ventilator-associated pneumonia, catheter-associated urinary tract infections, cellulitis, and neutropenic fever.  In each case, learners play the role of the rounding clinician 48-72 hours after admission.  First, they assess the admitting clinicianÕs empiric antimicrobial choice.  Then they step through the antibiotic timeout: review the data (clinical, laboratory, microbiologic); reassess and alter antibiotics if indicated, determine the anticipated duration of antibiotics needed, and document their decision-making.   Didactic content focuses upon IDSA guidelines and the optimization of antibiotic administration (including extended infusion beta-lactams, vancomycin dosing with therapeutic drug monitoring, and oral bioavailability.) 

    Results:  This course accrued 684 enrollees in 4 months.  20% (138/684) completed the post-course evaluation.  The majority of enrollees were physicians or pharmacists (57% and 22%, respectively.)  Learners indicated that they were better equipped to routinely conduct all the steps of the antibiotic timeout after completing the course and most reported that they planned to alter their practice (73%, 98/138.) Of those who do not intend to change practice, 78% (29/38) reported that the material validated their existing practice.  Only 32% apply for CME credit despite it being free.  Overall, 97% reported that the course met their educational needs. 

    Conclusion:  This novel online course was well received by learners and could be used to train front-line prescribers and complement ASP efforts to optimize antimicrobial use.

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    Marisa Holubar, MD, MS, Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, Kimberly Walker, PhD, Instructional Design and Production Group, Stanford University School of Medicine, Stanford, CA, Huy Tran, BA, Stanford University School of Medicine, Stanford, CA, Lina Meng, PharmD, Pharmacy, Stanford Health Care, Stanford, CA, Emily Mui, PharmD, Pharmacy, Stanford Hospital and Clinics, Stanford, CA, Elizabeth Robilotti, MD MPH, Infectious Diseases/Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY and Stan Deresinski, MD, FIDSA, Stanford University, Palo Alto, CA

    Disclosures:

    M. Holubar, None

    K. Walker, None

    H. Tran, None

    L. Meng, None

    E. Mui, None

    E. Robilotti, None

    S. Deresinski, 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.