Clinical Pharmacy Forum
Saturday, October 12, 2024
11:30 AM–01:00 PM
Abstract
Service or Program: The clinical pharmacy service, in collaboration with microbiology and laboratory services, at a 406-bed community hospital in Yuma, Arizona sought to decrease unnecessary and/or inappropriate use of broad spectrum antimicrobial agents in hospitalized adult patients with bloodstream infections (BSI). A pharmacist-driven blood culture identification protocol was created in which positive blood cultures tested by microbiology using the FilmArray® BCID2 panel, are directly reported, upon final result, to the clinical pharmacist. The pharmacist then interprets the BCID2 result, microorganism, and reported resistance markers (if any), to make targeted antimicrobial treatment recommendations to providers for optimal antimicrobial therapy.
Justification/Documentation: The BCID2 panel tests for 43 targets associated with BSI and 10 antimicrobial resistance genes in about an hour from positive blood culture. Rapid identification of microorganisms responsible for blood stream infections (BSI) and associated resistance markers are crucial for the early initiation of effective antibiotics, thus improving patient outcomes, reducing mortality, and antimicrobial stewardship efforts. Implementation of this protocol demonstrated a drastic reduction in the use of broad spectrum antibiotics by 88% upon initial implementation.
Adaptability: This pharmacist-driven protocol was implemented at a community hospital, situated in a geographically rural southwestern community that serves a diverse population including residents along both sides of the U.S. – Mexico border. The recommendations, in collaboration with microbiology services and the use of rapid diagnostic tests (RDTs), (BCID2), led to an increase in optimized antimicrobial therapy and could be implemented at other healthcare systems.
Significance: This protocol emphasizes the importance of inter-professional collaboration as well as highlights that clinical pharmacists are integral members of the health care team and are uniquely positioned to contribute to antimicrobial stewardship. Further, the use of RDTs can greatly reduce the time to optimal antimicrobial therapy.
Presenting Author
Rachel M Belcher PharmD, BCCCPYuma Regional Medical Center
Authors
Denisse Garcia Zavla PharmD
Yuma Regional Medical Center
Jacob Schwarz PharmD, MBA, BCIDP, BCCCP, BCPS, FAzPA
Yuma Regional Medical Center
Mikali Shedd PharmD, BCEMP
Yuma Regional Medical Center
Hailey Wang PharmD, BCPS
Yuma Regional Medical Center