988. Multicenter Study to evaluate the impact of Antibiotic Time Out in Four Community Hospitals
Session: Poster Abstract Session: Antibiotic Stewardship: General Acute Care Implementation and Outcomes
Friday, October 28, 2016
Room: Poster Hall
Posters
  • IDWeekposter2016RP.pdf (613.9 kB)
  • Background:

    In an effort to promote judicious use of antibiotics, the Centers for Disease Control (CDC), The President’s Council of Advisors on Science and Technology (PCAST) and Centers for Medicaid and Medicare Services (CMS) recommended that there be a regulatory requirement in place for antibiotic stewardship by the end of 2017. One of their recommendations is the implementation of an antibiotic time out. An antibiotic timeout is a structured process performed by clinicians to stop and review antibiotic therapy at a designated point in time to evaluate the appropriateness of the order. This ideally occurs between 48 to 72 hours after the antibiotic is initiated. This will be a major challenge in resource- limited non-teaching community hospitals with multiple private physician groups. We implemented a system-wide pharmacist-driven antibiotic time out at 72-hours in an effort to improve antibiotic utilization at our institutions.

    Methods:

    This is a multi-center pre-post quasi-experimental study conducted to analyze the impact of a pharmacist-driven antibiotic timeout on antibiotic utilization in three acute care community hospitals and one critical access hospital. All patients were evaluated by a pharmacist for antibiotic appropriateness after 72 hours. Potential interventions identified were addressed on multi-disciplinary rounds or with the ordering physician. The primary outcome measure is antibiotic days of therapy per 1000 patient days at risk (DOT). Secondary outcome measure is percent of interventions due to a time out by front line staff pharmacists. Outcomes will be compared to a historic control group.

    Results:

    Over the initial period (mid-April to mid-May) of the implementation of the antibiotic time out, a total of 335 patients were reviewed and there were 89 recommendations for change (26.6% intervention rate). Of these, 86 were accepted (96.6% acceptance rate). The majority of interventions accepted involved discontinuation of an antibiotic, followed by switch to oral or establishment of a duration.

    Conclusion:

    As shown by our data so far, a pharmacist-driven antibiotic time antibiotic time out protocol can be implemented in a resource limited community setting and lead to a positive impact on antimicrobial utilization.

    Radhika S. Polisetty, PharmD, BCPS, AQ-ID, Pharmacy Practice, Midwestern University Chicago College of Pharmacy, Downers Grove, IL; Pharmacy, Northwestern Medicine, Central DuPage Hospital, Winfield, IL, Jaime Borkowski, PharmD, BCPS, Pharmacy, Northwestern Medicine Delnor Hospital, Geneva, IL, Elizabeth Jochum, PharmD, BCPS, Pharmacy, KishHealth System, part of Northwestern Medicine, DeKalb, IL, Jennifer Delacruz, MD, MS, Infectious Diseases, Northwestern Medicine Central DuPage Hospital, Winfield, IL, Steven Lewis, MD, Infectious Disease, Northwestern Medicine Delnor Hopspital, Geneva, IL, Bob Manam, MD, Infectious Diseases, KishHealth System, part of Northwestern Medicine, Dekalb, IL, David Cooke, MD, Quality and Safety, Northwestern Memorial HealthCare, Winfield, IL and Luis Manrique, MD, Infectious Diseases, Notherwestern Medicine Central DuPage Hospital, Winfield, IL

    Disclosures:

    R. S. Polisetty, None

    J. Borkowski, None

    E. Jochum, None

    J. Delacruz, None

    S. Lewis, None

    B. Manam, None

    D. Cooke, None

    L. Manrique, 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.