• Diagn. Microbiol. Infect. Dis. · Oct 2018

    Impact of a stewardship-focused culture follow-up initiative on the treatment of pharyngitis in the emergency department and urgent care settings.

    • Lisa E Dumkow, Katie L Axford, K J Suda, Heather M Draper, and Kasey L Brandt.
    • Department of Pharmaceutical Services, Mercy Health Saint Mary's, 200 Jefferson SE, Grand Rapids, MI 49503, USA. Electronic address: lisa.dumkow@mercyhealth.com.
    • Diagn. Microbiol. Infect. Dis. 2018 Oct 1; 92 (2): 136-142.

    AbstractA culture follow-up program with an emphasis on symptom assessment may limit antibiotic exposure in patients with Group A Streptococcus on throat culture. A quasi-experimental study of such patients was conducted in our Emergency Department and Urgent Care centers. During the prestewardship initiative phase (March 2011-June 2012), the standard of care for culture follow-up did not include symptom assessment prior to prescribing antibiotics. During the stewardship initiative phase (March 2015-June 2016), culture follow-up was completed with a focus on symptom assessment and antibiotic avoidance. Two-hundred eighty patients were included. Antibiotic prescribing at follow-up decreased from 97.0% to 71.3% (P < 0.001); overall appropriateness of therapy at follow-up, including symptom assessment, increased from 6.0% to 81.5% (P < 0.001). There was no difference in 72-h revisit between the pre- and poststewardship initiative groups (P = 0.121). This study demonstrated improved antimicrobial prescribing with initiation of a stewardship-focused culture follow-up program in the Emergency Department and Urgent Care centers.Copyright © 2018 Elsevier Inc. All rights reserved.

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