• Am J Health Syst Pharm · Jan 2019

    Multicenter Study

    Pharmacist-led antimicrobial stewardship program in an urgent care setting.

    • Lauren N Fay, Lauren M Wolf, Kasey L Brandt, G Robert DeYoung, Adam M Anderson, Nnaemeka E Egwuatu, and Lisa E Dumkow.
    • Pharmacy Department, Mercy Health Saint Mary's, Grand Rapids, MI.
    • Am J Health Syst Pharm. 2019 Jan 25; 76 (3): 175-181.

    PurposeWhile many programs have demonstrated pharmacist-led antimicrobial stewardship successes in inpatient and emergency department (ED) settings, there is a paucity of literature exploring these initiatives in urgent care (UC) sites. This study aimed to determine the impact of implementing a pharmacist-led antimicrobial stewardship program (ASP) in the UC setting.MethodsA retrospective quasi-experimental study was conducted evaluating UC patients with positive urine or wound cultures following discharge. A collaborative practice agreement was implemented in 2015 allowing for pharmacist-led UC culture follow-up via a stewardship-focused protocol. The primary outcome of this study was to compare guideline-concordant antibiotic prescribing between the pre-ASP and post-ASP groups. Secondary outcomes included comparing the number of patients who required follow-up, time to follow-up, UC or ED revisits within 72 hours, and hospital admission within 30 days between groups.ResultsA total of 300 patients were included in the study (pre-ASP, n = 150; post-ASP, n = 150). Total guideline-concordant prescribing for all diagnoses was significantly improved in the post-ASP group (pre-ASP, 41.3% versus post-ASP 53.3%, p = 0.037). Additionally, guideline-concordant antibiotic selection improved in the post-ASP group (pre-ASP, 51% versus post-ASP, 68%, p = 0.01). Follow-up was required for 27 (18%) patients in the pre-ASP group compared with 16 (10.7%) in the post-ASP group (p = 0.07). Median time to follow-up call was longer in the post-ASP group (38 versus 71 hours, p < 0.001). There were no differences in UC and ED revisits within 72 hours (p = 1.0) or hospital admissions within 30 days (p = 0.723).ConclusionA pharmacist-led urgent care ASP was associated with significantly improved guideline-concordant antimicrobial prescribing.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…