Open AccessImpact of Combined Antimicrobial Stewardship Interventions to Improve Treatment of Patients With Staphylococcus aureus Bloodstream Infection (SAB) at a Tertiary Care Center
Author(s) -
Christina Sarubbi,
Michael D. Wolcott,
Rebekah W. Moehring,
Richard H. Drew,
Coleen K. Cunningham,
Michael J. Durkin,
Shera Watson,
Lauren P. Knelson,
Deverick J. Anderson
Publication year - 2015
Publication title -
open forum infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.546
H-Index - 35
ISSN - 2328-8957
DOI - 10.1093/ofid/ofv133.992
Subject(s) - antimicrobial stewardship , medicine , staphylococcus aureus , tertiary care , bloodstream infection , psychological intervention , antimicrobial , methicillin resistant staphylococcus aureus , center (category theory) , intensive care medicine , microbiology and biotechnology , antibiotics , antibiotic resistance , nursing , bacteria , chemistry , genetics , biology , crystallography
Methods: We performed a retrospective 3-arm study with quasi-experimental design to evaluate the impact of two policy changes implemented by the Duke Antimicrobial Stewardship and Evaluation Team (ASET). No policies regarding the care of patients with SAB were in place from 5/2012 through 4/2013 (Arm 1, control). From 5/2013 through 4/2014, all patients with SAB required automatic ID consultation (Arm 2). Arm 3 of our study (from 5/2014 though 4/2015) involved the use of both rapid diagnostic testing and automatic ID consultation. Time to appropriate therapy (our primary outcome) was calculated as the difference (in hours) from the time the first positive culture was drawn and the first admission of the appropriate therapy. Appropriate therapy within 48hrs of culture and process indicators were compared between groups.
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