English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Tools annual

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Presents the access of premium content as premium feature

Premium Content

Global: Zendy Plus annual

Global: Zendy Free Plan

Background Vancomycin and linezolid are antibiotics used in cases where methicillin-resistant Staphylococcus aureus (MRSA) is suspected, including in cases where MRSA is suspected to be the cause of pneumonia. MRSA nasal PCR has been shown to have a high negative predictive value when used to rule out MRSA pneumonia. The purpose of the current study was to determine whether a pharmacist-driven MRSA PCR nasal screening protocol would decrease the time to de-escalation or discontinuation of anti-MRSA therapy when utilized for pneumonia. Methods Patients were analyzed in two cohorts, those who received vancomycin or linezolid therapy from October 2012 to February 2013 (before pharmacist-driven MRSA nasal PCR protocol; n = 88) and those who received vancomycin from October 2016 to February 2017 (pharmacist-driven MRSA nasal PCR protocol; n = 105). During the study period, pharmacists were given the authority, via protocol to order an MRSA nasal PCR when vancomycin or linezolid was ordered for the indication of pneumonia. Subsequently, after a negative MRSA nasal PCR, pharmacists would contact the prescriber, and let the prescriber know that the MRSA PCR was negative, and then discontinue anti-MRSA therapy. The primary outcome was duration in hours of active anti-MRSA therapy. Secondary outcomes evaluated were the number of anti-MRSA antibiotic doses ordered, and the number of vancomycin troughs ordered. Results Patients in the pre-pharmacist driven cohort received vancomycin or linezolid for a median of 44.19 hours, whereas patients in the pharmacist-driven MRSA PCR protocol period received anti-MRSA therapy for a median of 19.1 hours (P &lt; 0.0001). Additionally, prior to the initiation of the pharmacist-driven MRSA nasal PCR protocol, patients received 349 doses of anti-MRSA therapy, compared with 283 doses in the pharmacist MRSA nasal swab protocol group (P &lt; 0.0001). There were also fewer vancomycin troughs ordered in the pharmacist MRSA nasal PCR protocol group (76 vs. 48, P &lt; 0.0009). Conclusion A pharmacist-driven protocol for ordering MRSA nasal PCR led to a statistically significant decrease in the time to discontinuation of vancomycin or linezolid for suspected MRSA pneumonia when the MRSA nasal PCR was negative. Disclosures All authors: No reported disclosures.

open forum infectious diseases

1999. Does Pharmacist-Driven Methicillin-Resistant Staphylococcus aureus PCR Nasal Screening Decrease Time to De-Escalation of MRSA Coverage in Patients with Pneumonia?