Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-22T05:57:36.975Z Has data issue: false hasContentIssue false

Impact of removing ESBL designation from culture reports on the selection of antibiotics for the treatment of infections associated with ESBL-producing organisms

Published online by Cambridge University Press:  06 April 2020

Mark D. Lesher*
Affiliation:
Department of Pharmacy, Milton S. Hershey Medical Center, Hershey, Pennsylvania
Cory M. Hale*
Affiliation:
Department of Pharmacy, Milton S. Hershey Medical Center, Hershey, Pennsylvania
Dona S. S. Wijetunge
Affiliation:
Pathology and Laboratory Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
Matt R. England
Affiliation:
Pathology and Laboratory Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
Debra S. Myers
Affiliation:
Pathology and Laboratory Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
David W. Craft
Affiliation:
Pathology and Laboratory Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
*
Author for correspondence: Mark Lesher, E-mail: [email protected]. Or Cory Hale, E-mail: [email protected]
Author for correspondence: Mark Lesher, E-mail: [email protected]. Or Cory Hale, E-mail: [email protected]

Abstract

We characterized the impact of removal of the ESBL designation from microbiology reports on inpatient antibiotic prescribing. Definitive prescribing of carbapenems decreased from 48.4% to 16.1% (P = .01) and β-lactam–β-lactamase inhibitor combination increased from 19.4% to 61.3% (P = .002). Our findings confirm the importance of collaboration between microbiology and antimicrobial stewardship programs.

Type
Concise Communication
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

a

Present affiliations: Texas Children’s Hospital/Baylor College of Medicine, Houston, Texas [D.S.S.W] and Summa Health, Akron City Hospital, Akron, Ohio [M.E.])

PREVIOUS PRESENTATION: Some of these data were previously presented as a poster at the ASM Microbe 2018 conference on June 8, 2018, in Atlanta, Georgia.

References

Wood, Lastair JJ. Drug therapy antimicrobial-drug resistance. N Engl J Med 1996;334:841848.Google Scholar
Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing: 20th informational supplement, CLSI document M100-S20. Wayne, PA: CLSI; 2010.Google Scholar
Katzman, M, Kim, J, Lesher, MD, et al. Customizing an electronic medical record to automate the workflow and tracking of an antimicrobial stewardship program, Open Forum Infect Dis 2019;6:ofz352.CrossRefGoogle ScholarPubMed
Tamma, PD, Han, JH, Rock, C, et al. Carbapenem therapy is associated with improved survival compared with piperacillin-tazobactam for patients with extended-spectrum β-lactamase bacteremia. Clin Infect Dis 2015;60:13191325.Google ScholarPubMed
Morency-Potvin, P, Schwartz, DN, Weinstein, RA. Antimicrobial stewardship: how the microbiology laboratory can right the ship. Clin Micro Rev 2017;30:381407.CrossRefGoogle Scholar
Cunney, RJ, Smyth, EG. The impact of laboratory reporting practice on antibiotic utilisation. Int J Antimicrob Agents 2000;14:1319.CrossRefGoogle ScholarPubMed
Musgrove, MA, Kenney, RM, Kendall, RE, Peters, M, Tibbetts, R, Samuel, L, Davis, SL. Microbiology comment nudge improves pneumonia prescribing. Open Forum Infect Dis 2018;5:ofy162.CrossRefGoogle ScholarPubMed
Harris, PN, Tambyah, PA, Lye, DC, et al. Effect of piperacillin-tazobactam versus meropenem on 30-day mortality for patients with E. coli or Klebsiella pneumoniae bloodstream infection and ceftriaxone resistance. JAMA 2018;320:984994.CrossRefGoogle ScholarPubMed
Vardakas, KZ, Tansarli, GS, Rafalidis, PI, Falagas, ME. Carbapenems versus alternative antibiotics for the treatment of bacteremia due to Enterobacteriaceae-producing extended-spectrum -lactamases: a systematic review and meta-analysis. J Antimicrob Chemother 2012;67:27932803.CrossRefGoogle ScholarPubMed
Wang, R, Cosgrove, SE, Tschudin-Sutter, S, et al. Cefepime therapy for cefepime-susceptible extended-spectrum -lactamase–producing Enterobacteriaceae bacteremia. Open Forum Infect Dis 2016;3(3):ofw132.CrossRefGoogle ScholarPubMed
Supplementary material: File

Lesher et al. supplementary material

Figures S1-S2 and Table S1

Download Lesher et al. supplementary material(File)
File 14.7 KB