scholarly journals An Antimicrobial Stewardship Program’s Impact with Rapid Polymerase Chain Reaction Methicillin‐ResistantStaphylococcus aureus/S. aureusBlood Culture Test in Patients withS. aureusBacteremia

2010 ◽  
Vol 51 (9) ◽  
pp. 1074-1080 ◽  
Author(s):  
Karri A. Bauer ◽  
Jessica E. West ◽  
Joan‐Miquel Balada‐Llasat ◽  
Preeti Pancholi ◽  
Kurt B. Stevenson ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Antimicrobial Stewardship ◽  
Chain Reaction ◽  
Culture Test ◽  
Rapid Polymerase Chain Reaction ◽  
Polymerase Chain

scholarly journals 1400. Impact of a Multiplex Polymerase Chain Reaction Meningitis/Encephalitis Panel and Antimicrobial Stewardship Bundle on Antimicrobial Use in Patients with Suspected Meningitis or Encephalitis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S509-S509
Author(s):  
Katelyn Woodbury ◽  
Megan Seddon ◽  
Andre McMahon ◽  
Jamie Kisgen
Keyword(s):  
Polymerase Chain Reaction ◽  
Median Time ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Therapy ◽  
Total Duration ◽  
Hospital Length Of Stay ◽  
Chain Reaction ◽  
Rapid Polymerase Chain Reaction ◽  
Significant Difference ◽  
Polymerase Chain

Abstract Background Optimal treatment of meningitis relies on prompt diagnostic evaluation and initiation of appropriate antimicrobials. The meningitis/encephalitis panel (MEP) is a multiplex rapid polymerase chain reaction, with the ability to detect 14 community-acquired pathogens in 1 hour. The purpose of this study was to evaluate impact of the MEP on de-escalation of antimicrobials in adult inpatients with suspected meningitis at a large community teaching hospital. Methods This single-center retrospective quasi-experimental pre/post study included adults admitted for ≥48 hours and initiated on antimicrobial therapy for suspected meningitis. Those with healthcare-associated meningitis, immunosuppression, initiation of antimicrobials >8 hours prior to lumbar puncture (LP), and use of antimicrobials for another indication were excluded. The pre-group included patients admitted prior to MEP introduction. The post-group included patients with the MEP performed. An antimicrobial stewardship bundle consisting of a meningitis order set, provider education, and use of a real-time meningitis alert in clinical decision support software was also implemented in the post-group. The primary outcome was percentage of patients experiencing antimicrobial de-escalation ≤48 hours after LP. Secondary outcomes included time to de-escalation, total duration of antimicrobial therapy (DOT), and hospital length of stay (LOS). Results A total of 45 patients were included in the study (23 pre-group and 22 post-group). Baseline characteristics were similar between groups. The percentage of patients experiencing de-escalation of antimicrobials ≤ 48 hours after LP increased by 44% in the post-group (82% vs. 38%, P = 0.005). The overall median time to de-escalation of antimicrobials decreased by 35 hours [11.1 (IQR 5.6, 17.6) vs. 46.1 (IQR 18.4, 66.5); P = 0.002] and the median time to de-escalation after LP decreased by 38 hours [13.6 (IQR 8.3, 20.3) vs. 51.6 (IQR 44.2, 69.8); P < 0.001]. No statistically significant difference in hospital LOS or total DOT was seen. Conclusion Implementation of the MEP and antimicrobial stewardship bundle increased the percentage of patients de-escalated in 48 hours and decreased the time to de-escalation. However, this did not impact the total DOT or hospital LOS. Disclosures All authors: No reported disclosures.

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