Antimicrobial Stewardship in the Emergency Department: Challenges, Opportunities, and a Call to Action for Pharmacists

Journal of Pharmacy Practice

Volumn 29, Issue 6, 2016, Pages 556-563

  Bishop, Bryan M ^a,b  

^a St Rita's Medical Center   (United States)

^b OHIO NORTHERN UNIVERSITY   (United States)

Author keywords

antimicrobial stewardship; emergency medicine; emergency medicine pharmacist; infectious disease; procalcitonin

Indexed keywords

COTRIMOXAZOLE; PROCALCITONIN; ANTIINFECTIVE AGENT;

ABSCESS; ANTIBIOTIC RESISTANCE; ANTIBIOTIC SENSITIVITY; ASYMPTOMATIC BACTERIURIA; BACTERIURIA; CELLULITIS; CLINICAL DECISION SUPPORT SYSTEM; CYSTITIS; EMERGENCY WARD; HEALTH SERVICE; HUMAN; LUNG ABSCESS; META ANALYSIS (TOPIC); METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS INFECTION; PHARMACIST; POLYMERASE CHAIN REACTION; POLYMERASE CHAIN REACTION SYSTEM; PRACTICE GUIDELINE; RANDOMIZED CONTROLLED TRIAL (TOPIC); RAPID TEST; REVIEW; SENSITIVITY AND SPECIFICITY; SEPSIS; STAPHYLOCOCCUS AUREUS; SYSTEMIC INFLAMMATORY RESPONSE SYNDROME; URINARY TRACT INFECTION; HOSPITAL EMERGENCY SERVICE; PROFESSIONAL STANDARD; STANDARDS;

ANTI-INFECTIVE AGENTS; DRUG RESISTANCE, MICROBIAL; EMERGENCY SERVICE, HOSPITAL; HUMANS; PHARMACISTS; PROFESSIONAL ROLE;

EID: 84994666705     PISSN: 08971900     EISSN: 15311937     Source Type: Journal    
DOI: 10.1177/0897190015585762     Document Type: Review

References (50)

1. Centers for Disease Control and Prevention. Core Elements of Hospital Antibiotic Stewardship Programs. Atlanta, GA: US Department of Health and Human Services, CDC; 2014. Web site. http://www.cdc.gov/getsmart/healthcare/implementation/core-elements.html. Updated March 4, 2014. Accessed September 9, 2014.
2. Dellit TH, Owens RC, McGowan JE, et al. Infectious diseases society of america and the society for healthcare epidemiology of america guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007; 44: 159-177.
3. Camins BC, King MD, Wells JB, et al. Impact of an antimicrobial utilization program on antimicrobial use at a large teaching hospital: a randomized controlled trial. Infect Control Hosp Epidemiol. 2009; 30 (10): 931-938.
4. Ingram PR, Seet JM, Budgeon CA, et al. Point-prevalence study of inappropriate antibiotic use at a tertiary Australian hospital. Intern Med J. 2012; 42 (6): 719-721.
5. Levin PD, Idrees S, Sprung CL, et al. Antimicrobial use in the ICU: indications and accuracy-an observational trial. J Hosp Med. 2012; 7 (9): 672-678.
6. Patel SJ, Oshodi A, Prasad P, et al. Antibiotic use in neonatal intensive care units and adherence with Centers for Disease Control and Prevention 12 Step Campaign to Prevent Antimicrobial Resistance. Pediatr infect Dis J. 2009; 28 (12): 1047-1051.
7. Fridkin SK, Baggs J, Fagan R, et al. Vital signs: improving antibiotic use among hospitalized patients. MMWR Morb Mortal Weekly Rep. 2014; 63 (9): 194-200.
8. Donnelly JP, Baddley JW, Wang HE,. Antibiotic utilization for acute respiratory tract infections in U.S. emergency departments. Antimicrob Agents Chemother. 2014; 58 (3): 1451-1457.
9. May L, Mullins P, Pines J,. Demographic and treatment patterns for infections in ambulatory settings in the United States, 2006-2010. Acad Emerg Med. 2014; 21 (1): 17-24.
10. Jenkins TC, Sabel AL, Sarcone EE, et al. Skin and soft-tissue infections requiring hospitalization at an academic medical center: opportunities for antimicrobial stewardship. Clin Infect Dis. 2010; 51 (8): 895-903.
11. May L, Cosgrove S, L'Archeveque M, et al. A call to action for antimicrobial stewardship in the emergency department: approaches and strategies. Ann Emerg Med. 2013; 62 (1): 69-77.
12. Kroening-Roche JC, Soroudi A, Castillo EM, et al. Antibiotic and bronchodilator prescribing for acute bronchitis in the emergency department. J Emerg Med. 2012; 43 (2): 221-227.
13. Samore MH, Bateman K, Alder SC, et al. Clinical decision support and appropriateness of antimicrobial prescribing: a randomized trial. JAMA. 2005; 294 (18); 2305-2314.
14. Aubert G, Carricajo A, Vautrin AC, et al. Impact of restricting fluoroquinolone prescription on bacterial resistance in an intensive care unit. J Hasp Infect. 2005; 59 (2): 83-89.
15. Brahmi N, Blel Y, Kouraichi N, et al. Impact of ceftazidime restriction on gram-negative bacterial resistance in an intensive care unit. J Infect Chemother. 2006; 12 (4): 190-194.
16. Baker SN, Acquisto NM, Ashley ED, et al. Pharmacist-managed antimicrobial stewardship program for patients discharged from the emergency department. J Pharm Pract. 2012; 25 (2): 190-194.
17. Dumkow LE, Kenney RM, MacDonald NC, et al. Impact of a multidisciplinary culture follow-up program of antimicrobial therapy in the emergency department. Infect Dis Ther. 2014; 3 (1): 45-53.
18. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis. 2014; 59 (2): e10-e52.
19. Kim A, Sutherland CA, Kuti JL, et al. Optimal dosing of piperacillin-tazobactam for the treatment of pseudomonas aeruginosa infections: prolonged or continuous infusion? Pharmacotherapy. 2007; 27 (11): 1490-1497.
20. Nicolau DP,. Pharmacodynamic optimization of β-lactams in the patient care setting. Crit Care. 2008; 12 (suppl 4): S2.
21. Hecker MT, Fox CJ, Son AH, et al. Effect of a stewardship intervention on adherence to uncomplicated cystitis and pyelonephritis guidelines in an emergency department setting. Plos One. 2014; 9 (2): e87899.
22. Nicolle LE, Bradley S, Colgan R, et al. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Inf Dis. 2005; 40 (5): 643-654.
23. File TM Jr, Solomkin JS, Cosgrove SE,. Strategies for improving antimicrobial use and the role of antimicrobial stewardship programs. Clin Inf Dis. 2011; 53 (S1): S15-S22.
24. Dalen DM, Zvonar RK, Jessamine PG,. An evaluation of the management of asymptomatic catheter-associated bacteriuria and candiduria at The Ottawa Hospital. Can J Infect Dis Med Microbiol. 2005; 16 (3): 166-170.
25. Gandhi T, Flanders SA, Markovitz E, et al. Importance of urinary tract infection to antibiotic use among hospitalized patients. Infect Control Hosp Epidemiol. 2009; 30 (2): 193-195.
26. Cope M, Cevallos ME, Cadle RM, et al. Inappropriate treatment of catheter-associated asymptomatic bacteriuria in a tertiary care hospital. Clin Infect Dis. 2009; 48 (9): 1182-1188.
27. Loeb M, Brazil K, Lohfeld L, et al. Effect of a multifaceted intervention on number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes: cluster randomised controlled trial. BMJ. 2005; 331 (7518): 669.
28. Pavese P, Saurel N, Labarere J, et al. Does an educational session with an infectious diseases physician reduce the use of inappropriate antibiotic therapy for inpatients with positive urine culture results? A controlled before-and-after study. Infect Control Hosp Epidemiol. 2009; 30 (6): 596-599.
29. Pallin DJ, Camargo CA, Schuur JD,. Skin infections and antibiotic stewardship: analysis of emergency department prescribing practices, 2007-2010. West J Emerg Med. 2014; 15 (3): 282-289.
30. Jeng A, Beheshti M, Li J, et al. The role of beta-hemolytic streptococci in causing diffuse, nonculturable cellulitis: a prospective investigation. Medicine (Baltimore). 2010; 89 (4): 217-226.
31. Bowen AC, Lilliebridge RA, Tong SY, et al. Is Streptococcus pyogenes resistant or susceptible to trimethoprim-sulfamethoxazole? J Clin Microbiol. 2012; 50 (12): 4067-4072.
32. Clinicaltrials.gov. Uncomplicated Skin and Soft Tissue Infections Caused by Community-Associated Methicillin-Resistant Staphylococcus Aureus. Web site. https://clinicaltrials.gov/ct2/show/NCT00730028. Published August 7, 2008. Updated May 7, 2015. Accessed February 19, 2015.
33. Clinicaltrials.gov. Strategies Using Off-Patent Antibiotics for Methicillin Resistant S. Aureus "STOP MRSA". Web site. https://clinicaltrials.gov/ct2/show/study/NCT00729937. Published August 7, 2008. Updated January 29, 2015. Accessed February 19, 2015.
34. Anzctr.org. An open label randomised controlled trial to determine if 5 days of once-daily oral trimethoprim-sulfamethoxazole or three days of twice-daily oral trimethoprim-sulfamethoxazole will lead to non-inferior cure rates of impetigo compared to a single dose of intramuscular benzathine penicillin G (the current gold standard treatment) in children living in remote Aboriginal communities between the age of 12 weeks to less than 13 years. Web site. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=83543. Published January 28, 2009. Accessed February 19, 2015.
35. Xpert MRSA/SA SSTI package brochure. Sunnyvale, CA: Cepheid; 2010.
36. Parta M, Goebel M, Matloobi M, et al. Identification of methicillin-resistant or methicillin-susceptible staphylococcus aureus in blood cultures and wound swabs by GeneXpert. J Clin Microbiol. 2009; 47 (5): 1609-1610. Letter.
37. Talan DA, Krishnadasa A, Terp SM, et al. Rapid MRSA PCR Testing in the emergency department reduces inappropriate antibiotics for patients hospitalized with skin and soft tissue infections [abstract]. In: Proceedings of the Infectious Diseases Society of America Annual Meeting; 2011 Oct 20-23; Boston, MA. Arlington (VA): IDSA; 2011. Abstract nr 226.
38. Clinicaltrials.gov. Antimicrobial stewardship through MRSA diagnosis in emergency department (ED) patients with abscesses. Web site. http://clinicaltrials.gov/ct2/show/NCT01523899. Published January 26, 2012. Updated March 9, 2015. Accessed September 9, 2014.
39. ® SeptiFast for the detection and identification of pathogens in the blood of patients with suspected sepsis: a systematic review protocol. BMJ Open. 2012; 2 (1): e000392.
40. Chang SS, Hsieh WH, Liu TS, et al. Multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis-a systemic review and meta-analysis. PLoS One. 2013; 8 (5): e62323.
41. Mencacci A, Leli C, Cardaccia A, et al. Procalcitonin predicts real-time PCR results in blood samples from patients with suspected sepsis. PLoS One. 2012; 7 (12): e53279.
42. Sakran JV, Michetti CP, Sheridan MJ, et al. The utility of procalcitonin in critically ill trauma patients. J Trauma Acute Care Surg. 2012; 73 (2): 413-418.
43. Schuetz P, Christ-Crain M, Thomann R, et al. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial. JAMA. 2009; 302 (10): 1059-1066.
44. Albrich WC, Dusemund F, Bucher B, et al. Effectiveness and safety of procalcitonin-guided antibiotic therapy in lower respiratory tract infections in "real life": an international, multicenter poststudy survey (ProREAL). Arch Intern Med. 2012; 172 (9): 715-722.
45. Tang J, Long W, Yan L, et al. Procalcitonin guided antibiotic therapy of acute exacerbations of asthma: a randomized controlled trial. BMC Infect Dis. 2013; 13: 596.
46. Muller F, Christ-Crain M, Bregenzer T, et al. Procalcitonin levels predict bacteremia in patients with community-acquired pneumonia: a prospective cohort trial. Chest. 2010; 138 (1): 121-129.
47. Hochreiter M, Kohler T, Schweiger AM, et al. Procalcitonin to guide duration of antibiotic therapy in intensive care patients: a randomized prospective controlled trial. Crit Care. 2009; 13 (3): R83.
48. Bishop BM, Bon JJ, Trienski TL, et al. Effect of introducing procalcitonin on antimicrobial therapy duration in patients with sepsis and/or pneumonia in the intensive care unit. Ann Pharmacother. 2014; 48 (5): 577-583.
49. Nobre V, Harbarth S, Graf JD, et al. Use of procalcitonin to shorten antibiotic treatment duration in septic patients: a randomized trial. Am J Respir Crit Care Med. 2008; 177 (5): 498-505.
50. Jensen JU, Hein L, Lundgren B, et al. Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: a randomized trial. Crit Care Med. 2011; 39 (9): 2048-2058.