Impact of a pharmacist-facilitated, evidence-based bundle initiative on Staphylococcus aureus bacteremia management.

Autor: Kufel WD; Binghamton University School of Pharmacy and Pharmaceutical Sciences, Binghamton, NY, USA; State University of New York Upstate Medical University, Syracuse, NY, USA; State University of New York Upstate University Hospital, Syracuse, NY, USA. Electronic address: wkufel@binghamton.edu., Mastro KA; Binghamton University School of Pharmacy and Pharmaceutical Sciences, Binghamton, NY, USA; State University of New York Upstate Medical University, Syracuse, NY, USA., Steele JM; State University of New York Upstate Medical University, Syracuse, NY, USA; State University of New York Upstate University Hospital, Syracuse, NY, USA., Wang D; State University of New York Upstate Medical University, Syracuse, NY, USA., Riddell SW; State University of New York Upstate Medical University, Syracuse, NY, USA; State University of New York Upstate University Hospital, Syracuse, NY, USA., Paolino KM; State University of New York Upstate Medical University, Syracuse, NY, USA; State University of New York Upstate University Hospital, Syracuse, NY, USA., Thomas SJ; State University of New York Upstate Medical University, Syracuse, NY, USA; State University of New York Upstate University Hospital, Syracuse, NY, USA.
Jazyk: angličtina
Zdroj: Diagnostic microbiology and infectious disease [Diagn Microbiol Infect Dis] 2021 Dec; Vol. 101 (4), pp. 115535. Date of Electronic Publication: 2021 Sep 04.
DOI: 10.1016/j.diagmicrobio.2021.115535
Abstrakt: Objective: To evaluate a pharmacist-facilitated evidence-based bundle (EBB) initiative with infectious disease consultation (IDC) for Staphylococcus aureus bacteremia (SAB).
Methods: This was a before-and-after quasi-experimental study of adult patients with SAB before and after the pharmacist-facilitated EBB initiative, which included IDC, timely definitive antibiotics, source control, echocardiography, and repeat blood cultures.
Results: Ninety and 111 patients were included in pre- and post-intervention cohorts, respectively. We observed significant increases in adherence to all 5 (4.4% vs 68.5%, P < 0.001) and 4 (10.0% vs 76.6%, P < 0.001) EBB elements. Time to definitive antibiotics (48 vs 16 hours, P < 0.001), time to IDC (43.5 vs 32 hours, P < 0.001), SAB duration (95 vs 66 hours, P = 0.009), persistent SAB (18.9% vs 9.0%, P = 0.041), and length of stay (14 vs 13 days, P = 0.027) also improved. No statistically significant differences for SAB-related readmission or all-cause mortality were observed.
Conclusions: Our pharmacist-facilitated SAB initiative was associated with improved EBB adherence and clinical outcomes.
Competing Interests: Declaration of competing interest Wesley D. Kufel has received research grants from Merck and Melinta Therapeutics, and served on the advisory board for Theratechnologies, Inc. Jeffrey M. Steele has served on the advisory board for Paratek Pharmaceuticals. All other others have nothing to disclose.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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