Is Preoperative Nasal Povidone-Iodine as Efficient and Cost-Effective as Standard Methicillin-Resistant Staphylococcus aureus Screening Protocol in Total Joint Arthroplasty?

2016 ◽  
Vol 31 (1) ◽  
pp. 215-218 ◽  
Author(s):  
Erick G. Torres ◽  
Jill M. Lindmair-Snell ◽  
Justin W. Langan ◽  
Brian G. Burnikel
Keyword(s):  
Staphylococcus Aureus ◽  
Total Joint Arthroplasty ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Povidone Iodine ◽  
Cost Effective ◽  
Joint Arthroplasty ◽  
Methicillin Resistant ◽  
Screening Protocol

scholarly journals Efficacy of a povidone iodine preparation in reducing nasal methicillin-resistant Staphylococcus aureus in colonized patients

2020 ◽  
Vol 48 (4) ◽  
pp. 456-459 ◽  
Author(s):  
Hussein Abou Ghaddara ◽  
Jessica A. Kumar ◽  
Jennifer L. Cadnum ◽  
Yilen K. Ng-Wong ◽  
Curtis J. Donskey
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Povidone Iodine ◽  
Methicillin Resistant

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

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S670-S670
Author(s):  
Dustin Waters ◽  
Anthony Putich
Keyword(s):  
Staphylococcus Aureus ◽  
Primary Outcome ◽  
Nasal Swab ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Protocol Group ◽  
Screening Protocol ◽  
High Negative Predictive Value ◽  
Linezolid Therapy ◽  
Rule Out

Abstract 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 < 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 < 0.0001). There were also fewer vancomycin troughs ordered in the pharmacist MRSA nasal PCR protocol group (76 vs. 48, P < 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.

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