Category: Federal Forum Posters
Purpose: High volumes of antimicrobials and cultures are prescribed and performed in the outpatient setting, often with little follow up. As an antimicrobial stewardship initiative, a pharmacist led culture review service originated. This study will evaluate the utility of a culture review service in the outpatient setting in a variety of locations including the emergency department, home based primary care, primary care, and various outpatient clinics. This study will also assess rates of intervention, treatment failure, 30 day re-presentation, 30 day admission, and 30 day all cause mortality. This study was approved as a quality assurance/quality improvement project.
Methods: This is a quasi-experimental study whereby the infectious disease pharmacist is alerted in real time when antimicrobials are ordered via the computerized patient record system. Antibiotics are reviewed and stratified based on culture status. Providers are contacted with disparate culture results. Antibiotic regimens are also evaluated for appropriateness in terms of dose, duration, antibiotic allergies, drug interactions, and QTc interval. This is a 7 day per week service. Microbiological tests and culture results, available via the electronic medical record, are reviewed daily to ensure timely interventions are made. Data will be presented via descriptive statistics. Risk factors such as Charlson score will be built into a multivariable logistic regression to determine impact on admission, re-presentation, and mortality.
Results: not applicable
Conclusion: not applicable
Bethany Wattengel– PGY2 Infectious Disease Pharmacy Resident, Western New York Veterans Affairs Healthcare System, Kenmore, NY