TY - JOUR
T1 - Effect of Antimicrobial Stewardship Program Guidance on the Management of Uncomplicated Skin and Soft Tissue Infections in Hospitalized Adults
AU - Walsh, Thomas L.
AU - Bremmer, Derek N.
AU - Moffa, Matthew A.
AU - Chan-Tompkins, Noreen H.
AU - Murillo, Monika A.
AU - Chan, Lynn
AU - Burkitt, Michael J.
AU - Konopka, Chelsea I.
AU - Watson, Courtney
AU - Trienski, Tamara L.
N1 - JavaScript is disabled on your browser. Please enable JavaScript to use all the features on this page. To assess the effect of an antimicrobial stewardship program (ASP)-bundled initiative on the appropriate use of antibiotics for uncomplicated skin and soft tissue infections (uSSTIs) at 2 academic medical centers in Pittsburgh, Pennsylvania.
PY - 2017/7
Y1 - 2017/7
N2 - OBJECTIVE: To assess the effect of an antimicrobial stewardship program (ASP)-bundled initiative on the appropriate use of antibiotics for uncomplicated skin and soft tissue infections (uSSTIs) at 2 academic medical centers in Pittsburgh, Pennsylvania.PATIENTS AND METHODS: A retrospective preintervention and postintervention study was conducted to compare management of patients admitted with uSSTIs before and after the implementation of the bundled initiative. The preintervention period was from August 1, 2014, through March 31, 2015, and the postintervention period was from August 1, 2015, through March 31, 2016.RESULTS: A total of 160 patients were included in the preintervention cohort, and 163 were included in the postintervention cohort. Compared with the preintervention group, the mean duration of therapy decreased (12.5 days vs 8.8 days;
P<.001) and an appropriate duration of less than 10 days increased in more patients (20.6% [33 of 160] vs 68.7% [112 of 163];
P<.001) in the postintervention period. Fewer patients were exposed to antimicrobials with extended gram-negative (44.4% [71 of 160] vs 9.2% [15 of 163];
P<.001), anaerobic (39.4% [63 of 160] vs 9.8% [16 of 163];
P<.001), and antipseudomonal (16.3% [26 of 160] vs 1.8% [3 of 163];
P<.001) coverage. The mean length of stay decreased from 3.6 to 2.2 days (
P<.001) without an increase in 30-day readmissions (6.3% [10 of 160] vs 4.9% [8 of 163];
P=.64). The ASP made recommendations for 125 patients, and 96% were accepted.
CONCLUSION: Implementation of an ASP-bundled approach aimed at optimizing antibiotic therapy in the management of uSSTIs led to shorter durations of narrow-spectrum therapy as well as shorter hospital length of stay without adversely affecting hospital readmissions.
AB - OBJECTIVE: To assess the effect of an antimicrobial stewardship program (ASP)-bundled initiative on the appropriate use of antibiotics for uncomplicated skin and soft tissue infections (uSSTIs) at 2 academic medical centers in Pittsburgh, Pennsylvania.PATIENTS AND METHODS: A retrospective preintervention and postintervention study was conducted to compare management of patients admitted with uSSTIs before and after the implementation of the bundled initiative. The preintervention period was from August 1, 2014, through March 31, 2015, and the postintervention period was from August 1, 2015, through March 31, 2016.RESULTS: A total of 160 patients were included in the preintervention cohort, and 163 were included in the postintervention cohort. Compared with the preintervention group, the mean duration of therapy decreased (12.5 days vs 8.8 days;
P<.001) and an appropriate duration of less than 10 days increased in more patients (20.6% [33 of 160] vs 68.7% [112 of 163];
P<.001) in the postintervention period. Fewer patients were exposed to antimicrobials with extended gram-negative (44.4% [71 of 160] vs 9.2% [15 of 163];
P<.001), anaerobic (39.4% [63 of 160] vs 9.8% [16 of 163];
P<.001), and antipseudomonal (16.3% [26 of 160] vs 1.8% [3 of 163];
P<.001) coverage. The mean length of stay decreased from 3.6 to 2.2 days (
P<.001) without an increase in 30-day readmissions (6.3% [10 of 160] vs 4.9% [8 of 163];
P=.64). The ASP made recommendations for 125 patients, and 96% were accepted.
CONCLUSION: Implementation of an ASP-bundled approach aimed at optimizing antibiotic therapy in the management of uSSTIs led to shorter durations of narrow-spectrum therapy as well as shorter hospital length of stay without adversely affecting hospital readmissions.
UR - https://www.sciencedirect.com/science/article/pii/S254245481730005X
UR - https://www.mendeley.com/catalogue/1d41af98-a7fb-31c0-bb61-e2e9c92f8d92/
U2 - 10.1016/j.mayocpiqo.2017.04.002
DO - 10.1016/j.mayocpiqo.2017.04.002
M3 - Article
C2 - 30225405
VL - 1
SP - 91
EP - 99
JO - Mayo Clinic Proceedings: Innovations, Quality Outcomes
JF - Mayo Clinic Proceedings: Innovations, Quality Outcomes
IS - 1
ER -