Category: Federal Forum Posters
Purpose: Antimicrobial stewardship initiatives continue to be a national priority and cornerstone in the fight against the continued emergence of multi-drug resistant organisms. Both the Joint Commission and Centers for Disease Control and Prevention recommend antibiotic “time-outs,” which systematically evaluate ongoing empiric antimicrobial therapies. IV vancomycin and IV piperacillin/tazobactam are two of the most common antibiotics used for empiric broad spectrum coverage at our health care system. This project was designed to evaluate the impact of a pharmacy-driven antibiotic time-out policy alerting providers to patients who might be appropriate for de-escalation or discontinuation of empiric broad spectrum coverage.
Methods: Anti-Methicillin Resistant Staphylococcus Aureus and broad spectrum gram negative de-escalation policies established by the Veterans Health Administration Antimicrobial Stewardship Task Force were adapted for local use at our institution. Based on criteria from these policies, a pharmacy-driven antibiotic time-out program was implemented on three inpatient wards and included general internal medicine, general surgery, vascular surgery, and orthopedic surgery patients. Each weekday, the infectious diseases pharmacist prints a daily list of patients who have received empiric therapy with IV vancomycin and/or IV piperacillin/tazobactam for at least 72 hours and will determine which patients are appropriate candidates for de-escalation/discontinuation. The clinical pharmacists responsible for medication management of these patients will make antibiotic time-out recommendations to providers using a templated note in the electronic health record. This project will conduct a qualitative assessment utilizing a retrospective chart review to determine the impact of the antibiotic time-out on duration of empiric broad spectrum therapy. The primary endpoint will be rate of de-escalation or discontinuation of these antibiotics within 24 hours of the recommended antibiotic time-out. Secondary outcomes include days of therapy per 1000 days present, patient demographics, medical service, and antibiotic indication.
Results: not applicable
Conclusion: not applicable
Jason Patterson– PGY1 Pharmacy Resident, VA Portland Health Care System, Overland Park, KS