1545. Reduction of Clostridium difficile Infection in a Community Teaching Hospital Associated with Antimicrobial Stewardship Team Interventions on Fluoroquinolone Utilization
Session: Poster Abstract Session: Stewardship: Improving Outcomes
Friday, October 6, 2017
Room: Poster Hall CD
Posters
  • ID_Week_2017_Final.pdf (536.6 kB)
  • Background: In April 2016, the Antimicrobial Stewardship Program (ASP) at Summa Health System – Akron Campus (SHS-AC) began reviewing all fluoroquinolone use in addition to other daily responsibilities. The decision to do so was made following the formation of a Clostridium difficile reduction taskforce, comprised of Infection Control, Environmental Services, and the ASP. The primary goal of the taskforce was to reduce cases of hospital acquired C.difficile infections by 10%. The ASP collectively decided to focus on fluoroquinolone antimicrobials during the first year of implementation.

    Methods: A retrospective review of all ASP interventions at SHS-AC was performed from April 2016-April 2017. The ASP reviewed all patients on a fluoroquinolone without Infectious Diseases consultation. The appropriateness of the the dose and assessment of EKGs (if available) was performed on all patients. Patients were reviewed for the following information: indication, renal function, contraindications (e.g. QTc prolongation), drug-drug interactions (e.g. warfarin), and allergy status. Data collected included: infection source, intervention type, acceptance rate, hospital acquired C.difficile rate, and fluoroquinolone utilization.

    Results: A total of 612 recommendations were made by the ASP on fluoroquinolone use, with a 95% acceptance rate. Interventions included: change to alternative agent based on indication or culture results (302/612), stop or change antimicrobials due to contraindication or major drug interaction (86/612), and discontinue antimicrobial use (224/612). Ciprofloxacin utilization decreased from 15.8 days of therapy (DOT)/1000 patient days in 2015, to 9.7 DOT/1000 patient days in 2016. Levofloxacin utilization decreased from 11.2 DOT/1000 patient days to 5.2 DOT/1000 patient days in 2016. The healthcare associated C.difficile infection rate also decreased from 7.24/10,000 patient days in 2015, to 4.78/10,000 patient days in 2016.

    Conclusion: Fluoroquinolone evaluation and intervention performed by the ASP resulted in a reduction of fluoroquinolone utilization and likely contributed to the reduction of healthcare associated C.difficile rates.

    Paula Politis, PharmD, BCPS, Pharmacy, Summa Health System, Akron, OH, Virginia Abell, BA, RN, CIC, Summa Health System, Akron, OH, Lisa Hoisington, PharmD, BCPS, Pharmacy, Summa Health System, Barberton, OH, Michael J. Tan, MD, FACP, FIDSA, Department of Medicine, Summa Health System, Akron, OH and Thomas M. File Jr., MD, Northeast Ohio Medical University, Rootstown, OH

    Disclosures:

    P. Politis, None

    V. Abell, None

    L. Hoisington, None

    M. J. Tan, None

    T. M. File Jr., None

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