Impact of stewardship pharmacist driven MRSA nasal surveillance and de-escalation of anti-MRSA therapy (STEW PHARM MRSA NASAL SURVEILLANCE)
Abstract Objective: To determine if implementing stewardship pharmacist-driven methicillin-resistant Staphylococcus aureus (MRSA) nasal surveillance increases use of the test and reduces the inappropriate use of vancomycin for MRSA coverage in patients with pneumonia. Design: Retrospective pre-/...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2024-01-01
|
| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X24004431/type/journal_article |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846127050852663296 |
|---|---|
| author | Jessica Dillon Domenic Vita Jessica Abrantes-Figueiredo Dora Wiskirchen |
| author_facet | Jessica Dillon Domenic Vita Jessica Abrantes-Figueiredo Dora Wiskirchen |
| author_sort | Jessica Dillon |
| collection | DOAJ |
| description |
Abstract
Objective:
To determine if implementing stewardship pharmacist-driven methicillin-resistant Staphylococcus aureus (MRSA) nasal surveillance increases use of the test and reduces the inappropriate use of vancomycin for MRSA coverage in patients with pneumonia.
Design:
Retrospective pre-/post-intervention study.
Setting:
Large teaching acute care hospital.
Participants:
Adult patients receiving vancomycin therapy for treatment of pneumonia.
Methods:
A stewardship pharmacist ran a report of admitted patients receiving vancomycin and reviewed the patients’ records. If the patient’s indication was pneumonia and a MRSA nasal swab had not been ordered, the pharmacist contacted the patient’s provider and requested an order for it. Upon receipt of a negative MRSA nasal swab result, the pharmacist recommended discontinuation of vancomycin if appropriate.
The control group was four weeks prior to the stewardship intervention, where there was no dedicated stewardship pharmacist reviewing MRSA swab utilization. The primary outcome was percentage of patients who had a MRSA swab ordered. Secondary outcomes included percentage of patients who had vancomycin appropriately de-escalated based on MRSA nasal swab results and length of vancomycin therapy.
Result:
Percentage of swabs ordered increased from 36.1% (22/61) to 83.7% (41/49) with pharmacist intervention (P < 0.0001). The rate of vancomycin de-escalation following a negative MRSA swab increased from 19.7% (12/61) to 61.2% (30/49) with pharmacist intervention (P < 0.0001).
Conclusion:
The results suggest implementing a pharmacist driven MRSA nasal surveillance program into practice could increase the number of MRSA nasal swabs ordered and promote timely de-escalation of vancomycin in patients with pneumonia.
|
| format | Article |
| id | doaj-art-d5c278ce016849bc91e773773bfad33c |
| institution | Kabale University |
| issn | 2732-494X |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj-art-d5c278ce016849bc91e773773bfad33c2024-12-12T05:43:38ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2024-01-01410.1017/ash.2024.443Impact of stewardship pharmacist driven MRSA nasal surveillance and de-escalation of anti-MRSA therapy (STEW PHARM MRSA NASAL SURVEILLANCE)Jessica Dillon0https://orcid.org/0009-0002-9046-5129Domenic Vita1Jessica Abrantes-Figueiredo2https://orcid.org/0000-0002-0942-493XDora Wiskirchen3Department of Pharmacy, Saint Francis Hospital and Medical Center, Hartford, CT, USADepartment of Pharmacy, Saint Francis Hospital and Medical Center, Hartford, CT, USADepartment of Infectious Disease, Saint Francis Hospital and Medical Center, Hartford, CT, USADepartment of Pharmacy, Saint Francis Hospital and Medical Center, Hartford, CT, USA Abstract Objective: To determine if implementing stewardship pharmacist-driven methicillin-resistant Staphylococcus aureus (MRSA) nasal surveillance increases use of the test and reduces the inappropriate use of vancomycin for MRSA coverage in patients with pneumonia. Design: Retrospective pre-/post-intervention study. Setting: Large teaching acute care hospital. Participants: Adult patients receiving vancomycin therapy for treatment of pneumonia. Methods: A stewardship pharmacist ran a report of admitted patients receiving vancomycin and reviewed the patients’ records. If the patient’s indication was pneumonia and a MRSA nasal swab had not been ordered, the pharmacist contacted the patient’s provider and requested an order for it. Upon receipt of a negative MRSA nasal swab result, the pharmacist recommended discontinuation of vancomycin if appropriate. The control group was four weeks prior to the stewardship intervention, where there was no dedicated stewardship pharmacist reviewing MRSA swab utilization. The primary outcome was percentage of patients who had a MRSA swab ordered. Secondary outcomes included percentage of patients who had vancomycin appropriately de-escalated based on MRSA nasal swab results and length of vancomycin therapy. Result: Percentage of swabs ordered increased from 36.1% (22/61) to 83.7% (41/49) with pharmacist intervention (P < 0.0001). The rate of vancomycin de-escalation following a negative MRSA swab increased from 19.7% (12/61) to 61.2% (30/49) with pharmacist intervention (P < 0.0001). Conclusion: The results suggest implementing a pharmacist driven MRSA nasal surveillance program into practice could increase the number of MRSA nasal swabs ordered and promote timely de-escalation of vancomycin in patients with pneumonia. https://www.cambridge.org/core/product/identifier/S2732494X24004431/type/journal_article |
| spellingShingle | Jessica Dillon Domenic Vita Jessica Abrantes-Figueiredo Dora Wiskirchen Impact of stewardship pharmacist driven MRSA nasal surveillance and de-escalation of anti-MRSA therapy (STEW PHARM MRSA NASAL SURVEILLANCE) Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Impact of stewardship pharmacist driven MRSA nasal surveillance and de-escalation of anti-MRSA therapy (STEW PHARM MRSA NASAL SURVEILLANCE) |
| title_full | Impact of stewardship pharmacist driven MRSA nasal surveillance and de-escalation of anti-MRSA therapy (STEW PHARM MRSA NASAL SURVEILLANCE) |
| title_fullStr | Impact of stewardship pharmacist driven MRSA nasal surveillance and de-escalation of anti-MRSA therapy (STEW PHARM MRSA NASAL SURVEILLANCE) |
| title_full_unstemmed | Impact of stewardship pharmacist driven MRSA nasal surveillance and de-escalation of anti-MRSA therapy (STEW PHARM MRSA NASAL SURVEILLANCE) |
| title_short | Impact of stewardship pharmacist driven MRSA nasal surveillance and de-escalation of anti-MRSA therapy (STEW PHARM MRSA NASAL SURVEILLANCE) |
| title_sort | impact of stewardship pharmacist driven mrsa nasal surveillance and de escalation of anti mrsa therapy stew pharm mrsa nasal surveillance |
| url | https://www.cambridge.org/core/product/identifier/S2732494X24004431/type/journal_article |
| work_keys_str_mv | AT jessicadillon impactofstewardshippharmacistdrivenmrsanasalsurveillanceanddeescalationofantimrsatherapystewpharmmrsanasalsurveillance AT domenicvita impactofstewardshippharmacistdrivenmrsanasalsurveillanceanddeescalationofantimrsatherapystewpharmmrsanasalsurveillance AT jessicaabrantesfigueiredo impactofstewardshippharmacistdrivenmrsanasalsurveillanceanddeescalationofantimrsatherapystewpharmmrsanasalsurveillance AT dorawiskirchen impactofstewardshippharmacistdrivenmrsanasalsurveillanceanddeescalationofantimrsatherapystewpharmmrsanasalsurveillance |