A Review of Antibiotic Prophylaxis for Interventional Radiology Procedures and Identification of Antimicrobial Stewardship Opportunities

BACKGROUND: Antibiotics used for peri-procedural prophylaxis are dispensed by providers or nurses from automated dispensing machines in the interventional radiology (IR) suites. These antibiotics are administered without pharmacist review which skips a critical point in time for antimicrobial stewardship intervention. The purpose of this study was to evaluate antibiotic prophylaxis for IR procedures and identify opportunities for antimicrobial stewardship. METHODS: All patients who underwent an IR procedure and received antibiotic prophylaxis from April 2016 to April 2017 were identified. We performed a manual chart review to determine procedure type, antibiotic prophylaxis, concomitant systemic antibiotics, and antibiotic concordance with the Society of Interventional Radiology (SIR) guidelines. RESULTS: There were 410 IR procedures where the patient received a single prophylactic antibiotic dose; 261 were inpatient procedures. See Table 1 for procedure and antibiotic data. There were 74 patients (18%) who concomitantly received systemic antibiotics. There were 126 cases (31%) discordant with the SIR guidelines. Reasons for discordance include prophylaxis not recommended, inappropriate antibiotic selection, or patient already receiving an antibiotic with similar spectrum of coverage. CONCLUSION: Antibiotics are frequently administered as prophylaxis for IR procedures. For many IR procedures, data to support prophylaxis is limited; however, there are opportunities for antimicrobial stewardship intervention which include optimizing antibiotic selection and withholding prophylaxis when not indicated or when patients are receiving systemic antibiotics. DISCLOSURES: All authors: No reported disclosures.