• Stephanie Shealy May, John J Veillette, Brandon J Webb, Edward A Stenehjem, Steven K Throneberry, Stephanie Gelman, Michael Pirozzi, Valoree Stanfield, Dustin WatersCCDepartment of Pharmacy, McKay-Dee Hospital, Ogden, Utah, USA., Nancy A Grisel, and Todd J Vento.
• Infectious Diseases Telehealth Services, Intermountain Healthcare, Murray, Utah, USA.
• J Hosp Med. 2023 Aug 1; 18 (8): 719723719-723.

AbstractAntibiotic stewardship interventions are urgently needed to reduce antibiotic overuse in hospitalized COVID-19 patients, particularly in small community hospitals (SCHs), who often lack access to infectious diseases (ID) and stewardship resources. We implemented multidisciplinary tele-COVID rounds plus tele-antibiotic stewardship surveillance in 17 SCHs to standardize COVID management and evaluate concurrent antibiotics for discontinuation. Antibiotic use was compared in the 4 months preintervention versus 10 months postintervention. Interrupted time-series analysis demonstrated an immediate decrease in antibiotic use by 339 days of therapy/1000 COVID-19 patient days (p < .001), and an estimated 5258 antibiotic days avoided during the postintervention period. Thirty-day mortality was not significantly different, and a significant reduction in transfers was observed following the intervention (23.3% vs. 7.8%, p < .001). A novel tele-ID and tele-stewardship intervention significantly decreased antibiotic use and transfers among COVID-19 patients at 17 SCHs, demonstrating that telehealth is a feasible way to provide ID expertise in community and rural settings.© 2023 Society of Hospital Medicine.

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