Category: Federal Forum Posters
Purpose: Procalcitonin has been extensively studied to provide objective data by using threshold levels to determine the need for antibiotic therapy. The purpose of this quality improvement (QI) project is to implement a procalcitonin-guided protocol to reduce inappropriate prescribing of antibiotics for acute respiratory infections (ARI) in the emergency department. The project outcomes include optimizing antimicrobial stewardship, providing prescribers the necessary tools to guide therapy, and minimizing risks associated with inappropriate antibiotic prescribing.
Methods: The Institutional Review Board reviewed the project and determined as non-research QI activity. A procalcitonin-guided antibiotic prescribing tool will be developed and utilized in the emergency department. Targeted disease states will include ARI defined as pharyngitis, rhinosinusitis, bronchitis and upper respiratory infections-not otherwise specified. A retrospective chart review will be conducted on patients seen in the emergency department for ARI from October 2017 to March 2018 to obtain the following: total ARI cases, total cases of uncomplicated ARI with antibiotic prescribed, and overall prescribing rate. The protocol will utilize a procalcitonin threshold of >0.25ng/mL (indicative of an ongoing bacterial infection) to indicate use of an antibiotic. Patients will then be identified through the VA ARI clinical dashboard from time of protocol initiation between October2018 and March 2019 . Once patients are identified, follow-up via phone call will be conducted to assess clinical response (i.e. improvement or persistence of symptoms) and adverse effects from antibiotics 3 to 5 days after emergency department visit. Data collected will be used to trend and compare ARI antibiotic prescribing rates before and after protocol implementation.
Results: Not applicable
Conclusion: Not applicable
Aira Joy Canlapan– PGY1 Resident, VA Sierra Nevada Health Care System (Reno, NV), Reno, NV