Category: Professional Posters
Purpose: A drug use evaluation revealed that most aztreonam use in our facility was considered inappropriate and ordered mainly for patients labeled with a beta-lactam allergy. Due to the high cost, risk of resistance, and limited coverage of aztreonam, this project was designed to reduce our aztreonam utilization.
Methods: A committee of four pharmacists was formed to develop materials to educate both pharmacists and providers about beta-lactam allergies. Pharmacists were required to complete a continuing education course that focused on beta-lactam allergies and complete an accompanying quiz that the committee had created. A tool was also developed by the committee to assist pharmacists in reviewing aztreonam orders for appropriateness accompanied by alternative antibiotic options to recommend to providers. The decision for recommending alternative antibiotics focused on the risk of cross-reactivity between beta-lactams based upon the structure of their side chains. Education for providers highlighted how to minimize aztreonam use by carefully reviewing patients’ allergy information (allergy versus intolerance), antibiotic history, and risks of beta-lactam cross-reactivity.
Results: Aztreonam use was monitored monthly by days of therapy which was reported through the antimicrobial stewardship metrics. The goal was to decrease aztreonam days of therapy by 5 percent with an intermediate stretch goal of 7.5 percent and a stretch goal of 10 percent for the year 2018. Aztreonam utilization was reduced by 44.4 percent in 2018 compared to 2017.
Conclusion: Pharmacist and provider education resulted in a reduction in aztreonam utilization at our facility. Education to both pharmacists and providers improved knowledge gaps for antibiotic selection in patients with beta-lactam allergies.