Pharmacist-led antimicrobial stewardship program in an urgent care setting

Autor:	Kasey L. Brandt, Adam M Anderson, Lisa E. Dumkow, G. Robert Deyoung, Lauren M. Wolf, Lauren N Fay, Nnaemeka Egwuatu
Rok vydání:	2019
Předmět:	Adult Male medicine.medical_specialty Adolescent pharmacist Pharmacist MEDLINE urgent care Pharmacists 030226 pharmacology & pharmacy Communicable Diseases Antibiotic prescribing Care setting 03 medical and health sciences Young Adult 0302 clinical medicine Professional Role Anti-Infective Agents medicine Ambulatory Care Antimicrobial stewardship Humans 030212 general & internal medicine Young adult guideline adherence Retrospective Studies Pharmacology business.industry Health Policy Retrospective cohort study Emergency department Middle Aged antimicrobial stewardship Emergency medicine Practice Research Reports wound infection Female business urinary tract infection Follow-Up Studies
Zdroj:	American Journal of Health-System Pharmacy
ISSN:	1535-2900
Popis:	Purpose While many programs have demonstrated pharmacist-led antimicrobial stewardship successes in inpatient and emergency department (ED) settings, there is a paucity of literature exploring these initiatives in urgent care (UC) sites. This study aimed to determine the impact of implementing a pharmacist-led antimicrobial stewardship program (ASP) in the UC setting. Methods A retrospective quasi-experimental study was conducted evaluating UC patients with positive urine or wound cultures following discharge. A collaborative practice agreement was implemented in 2015 allowing for pharmacist-led UC culture follow-up via a stewardship-focused protocol. The primary outcome of this study was to compare guideline-concordant antibiotic prescribing between the pre-ASP and post-ASP groups. Secondary outcomes included comparing the number of patients who required follow-up, time to follow-up, UC or ED revisits within 72 hours, and hospital admission within 30 days between groups. Results A total of 300 patients were included in the study (pre-ASP, n = 150; post-ASP, n = 150). Total guideline-concordant prescribing for all diagnoses was significantly improved in the post-ASP group (pre-ASP, 41.3% versus post-ASP 53.3%, p = 0.037). Additionally, guideline-concordant antibiotic selection improved in the post-ASP group (pre-ASP, 51% versus post-ASP, 68%, p = 0.01). Follow-up was required for 27 (18%) patients in the pre-ASP group compared with 16 (10.7%) in the post-ASP group (p = 0.07). Median time to follow-up call was longer in the post-ASP group (38 versus 71 hours, p < 0.001). There were no differences in UC and ED revisits within 72 hours (p = 1.0) or hospital admissions within 30 days (p = 0.723). Conclusion A pharmacist-led urgent care ASP was associated with significantly improved guideline-concordant antimicrobial prescribing.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::aa7248045c8437105ba81d66aa9f6b3d https://pubmed.ncbi.nlm.nih.gov/30689745 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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