Category: Federal Forum Posters
Purpose: The severity of MRSA infections combined with the increased emergence of community-onset MRSA, and the issuance of guidelines for management of sepsis, hospital-acquired pneumonia, and skin and soft tissue infections that recommend empiric anti-MRSA therapy for severely ill patients with risk for MRSA infection, has led to a dramatic increase in the empiric use of vancomycin despite decreases in the frequency with which MRSA is identified in clinical specimens. The purpose of this project is to evaluate the appropriateness of initiation and de-escalation of vancomycin therapy in VA Caribbean Healthcare System (VACHS) hospitalized patients with suspected community-onset infections.
Methods: The prescribing practices for intravenous vancomycin among hospitalized veterans from June 1, 2017 to May 31, 2018 at VACHS will be study as part of a retrospective multi-centered medication use evaluation. A maximum of 150 eligible patients will be evaluated. The cohort is comprised of acute care patients in whom intravenous vancomycin is initiated during the first two days of hospitalization in an acute care unit and who received no other recent prior therapy directed against MRSA. The cohort will be identified by the Pharmacy Benefits Management (PBM) VA Center for Medication Safety (VAMedSAFE) and the VA Salt Lake City (SLC) IDEAS 2.0 Group. Potential cases will be screen within the VA’s electronic health record CPRS (“Computerized Patient Record System”) for inclusion and exclusion criteria. A full chart review will be conducted to evaluate MUE pre-established indicators. Variables to be measured include: demographics, diagnosis, anti-MRSA agents prescribed, vital signs, laboratory values, microbiology, duration of therapy, among others. These variables will be evaluated at vancomycin initiation and de-escalation day of interest, defined as day 1 and 4, respectively. Descriptive statistics will be used to summarize demographics. MUE indicators will be presented as proportions with 95% confidence intervals.
Results: Not applicable
Conclusion: Not applicable
Keyla Rivera-Ruiz– PGY1 Pharmacy Resident, VA Caribbean Healthcare System, Sabana Hoyos, Puerto Rico