Implementation of an Automated Antibiotic Time-out at a Comprehensive Cancer Center.
Open Forum Infect Dis
; 11(5): ofae235, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38798895
ABSTRACT
Background:
Antimicrobial stewardship programs can optimize antimicrobial use and have been federally mandated in all hospitals. However, best stewardship practices in immunocompromised patients with cancer are not well established.Methods:
An antimicrobial time out, in the form of an email, was sent to physicians caring for hospitalized patients reaching 5 days of therapy for targeted antimicrobials (daptomycin, linezolid, tigecycline, vancomycin, imipenem/cilastatin, meropenem) in a comprehensive cancer center. Physicians were to discontinue the antimicrobial if unnecessary or document a rationale for continuation. This is a quasi-experimental, interrupted time series analysis assessing antimicrobial use during the following times period 1 (before time-out January 2007-June 2010) and period 2 (after time-out July 2010-March/2015). The primary antimicrobial consumption metric was mean duration of therapy. Days of therapy per 1000 patient-days were also assessed.Results:
Implementation of the time-out was associated with a significant decrease in mean duration of therapy for the following antimicrobials; daptomycin -0.89 days (95% confidence interval [CI], -1.38 to -.41); linezolid -0.89 days (95% CI, -1.27 to -.52); meropenem -0.97 days (95% CI, -1.39 to -.56); tigecycline -1.41 days (95% CI, -2.19 to -.63); P < .001 for each comparison. Days of therapy/1000 patient-days decreased significantly for meropenem (-43.49; 95% CI, -58.61 to -28.37; P < .001), tigecycline (-35.47; 95% CI, -44.94 to -26.00; P < .001), and daptomycin (-9.47; 95% CI, -15.25 to -3.68; P = .002).Discussion:
A passive day 5 time-out was associated with reduction in targeted antibiotic use in a cancer center and could potentially be successfully adopted to several settings and electronic health records.
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Bases de dados:
MEDLINE
Idioma:
En
Revista:
Open Forum Infect Dis
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos