1591. Impact of Antimicrobial Stewardship Program Guidance on the Management of Community-Acquired Pneumonia in Hospitalized Adults
Session: Poster Abstract Session: Stewardship: Improving Outcomes
Friday, October 6, 2017
Room: Poster Hall CD
  • ABSCAP (1).pdf (402.5 kB)
  • Background: Community-acquired pneumonia (CAP) is often treated with prolonged antibiotic therapy and unnecessary utilization of broad-spectrum antibiotics. An Antimicrobial Stewardship Program (ASP) bundled initiative, which included dissemination of a clinical decision algorithm, procalcitonin guidance, and prospective audit with feedback by the ASP team, was implemented.

    Methods: A retrospective, pre-intervention/post-intervention study was conducted to compare management for patients admitted with CAP before and after implementation of the ASP-bundled initiative. The pre-intervention period was March 1, 2014 through October 31, 2014, and the intervention period was September 1, 2015 through April 30, 2016.

    Results: A total of 39 and 61 patients were included in the pre-intervention and post-intervention cohorts, respectively. When compared with the pre-intervention group, mean duration of therapy decreased (9.0 vs 5.6 days; P < 0.001). More patients received an appropriate duration of 7 days or less (38.5% vs 80.3%; P < 0.001), while fewer received courses of more than 10 days (28.2% vs 3.3%; P < 0.001). Fewer patients received intravenous vancomycin (28.2% vs 4.9%; P = 0.002) and anti-pseudomonal beta-lactams (25.6% vs 6.6%; P = 0.02). Pneumonia-related 30-day re-admission rates (5.1% vs 4.9%; P = 0.99) were unaffected. In the post-intervention group, patients with procalcitonin levels < 0.25µg/L received shorter duration of therapy compared to patients with levels > 0.25µg/L (4.5 vs 6.9 days; P = 0.001).

    Conclusion: A syndrome-specific approach to antimicrobial stewardship practices, incorporating procalcitonin-guidance, led to shorter durations of therapy and decreased use of broad-spectrum antibiotics for the treatment of CAP without affecting hospital re-admissions.


    Thomas Walsh, MD1, Matthew Moffa, DO1, Holly Bean, DO2, Courtney Watson, MPH1 and Derek Bremmer, PharmD, BCPS1, (1)Allegheny Health Network, Pittsburgh, PA, (2)Infectious Disease, Allegheny Health Network, Pittsburgh, PA


    T. Walsh, None

    M. Moffa, None

    H. Bean, None

    C. Watson, None

    D. Bremmer, None

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