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1098. Perioperative Antibiotic Stewardship for Interventional Radiology Cases Improves Antibiotic Decision-Making

BACKGROUND: Appropriate periprocedural antibiotic prophylaxis is critical to optimize in order to reduce excessive antibiotics exposure for patients and to minimize the risk for procedure-related infection. Wrong antibiotic or excess antibiotics increase the risk for development of antimicrobial res...

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Autores principales: Sterling, Stephanie, Decano, Arnold, Fabian, Evelyn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811173/
http://dx.doi.org/10.1093/ofid/ofz360.962
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author Sterling, Stephanie
Decano, Arnold
Fabian, Evelyn
author_facet Sterling, Stephanie
Decano, Arnold
Fabian, Evelyn
author_sort Sterling, Stephanie
collection PubMed
description BACKGROUND: Appropriate periprocedural antibiotic prophylaxis is critical to optimize in order to reduce excessive antibiotics exposure for patients and to minimize the risk for procedure-related infection. Wrong antibiotic or excess antibiotics increase the risk for development of antimicrobial resistance, Clostridium difficile infection, adverse side effects. Incorrect or missed antibiotic can put the patient at risk for an infection. METHODS: Interventions included education of vascular and interventional radiology (IR) consult RN and physicians regarding updated institutional antimicrobial prophylaxis guidelines for vascular and IR procedures, creation of a consulting template that incorporated ongoing antibiotics. Review of recent cultures was incorporated into workflow and consult evaluation. Handoff between the IR RN and IR attendings was expanded to include a review of antimicrobials. RESULTS: All IR cases were reviewed for antibiotic administration for 3 months pre- and post-intervention. In the pre-intervention timeframe, 23 of 290 procedures (7.9%) were associated with inappropriate antibiotic administration, further delineated as 6 cases where no antibiotics were given, 7 cases of inappropriate antibiotics administered, and 10 cases where extraneous antibiotics were administered. Of the 39 total procedures where antibiotics were indicated, 17 (43.6%) were associated with antibiotic errors. In the post-intervention period, only 9 of 309 total procedures (10.3%) were associated with inappropriate antibiotic administration: missed antibiotics in 3 cases, inappropriate antibiotics in 4 cases, and unnecessary antibiotics in 2 cases. Of the 32 cases where antibiotics were indicated, only 7 (21.9%) were associated with antibiotic errors. CONCLUSION: Incorporating current antibiotics and review of culture data in a preoperative review and template for patients who need a surgical procedure helps guide appropriate antibiotic decision-making and greatly decreases administration of unnecessary antibiotics. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68111732019-10-29 1098. Perioperative Antibiotic Stewardship for Interventional Radiology Cases Improves Antibiotic Decision-Making Sterling, Stephanie Decano, Arnold Fabian, Evelyn Open Forum Infect Dis Abstracts BACKGROUND: Appropriate periprocedural antibiotic prophylaxis is critical to optimize in order to reduce excessive antibiotics exposure for patients and to minimize the risk for procedure-related infection. Wrong antibiotic or excess antibiotics increase the risk for development of antimicrobial resistance, Clostridium difficile infection, adverse side effects. Incorrect or missed antibiotic can put the patient at risk for an infection. METHODS: Interventions included education of vascular and interventional radiology (IR) consult RN and physicians regarding updated institutional antimicrobial prophylaxis guidelines for vascular and IR procedures, creation of a consulting template that incorporated ongoing antibiotics. Review of recent cultures was incorporated into workflow and consult evaluation. Handoff between the IR RN and IR attendings was expanded to include a review of antimicrobials. RESULTS: All IR cases were reviewed for antibiotic administration for 3 months pre- and post-intervention. In the pre-intervention timeframe, 23 of 290 procedures (7.9%) were associated with inappropriate antibiotic administration, further delineated as 6 cases where no antibiotics were given, 7 cases of inappropriate antibiotics administered, and 10 cases where extraneous antibiotics were administered. Of the 39 total procedures where antibiotics were indicated, 17 (43.6%) were associated with antibiotic errors. In the post-intervention period, only 9 of 309 total procedures (10.3%) were associated with inappropriate antibiotic administration: missed antibiotics in 3 cases, inappropriate antibiotics in 4 cases, and unnecessary antibiotics in 2 cases. Of the 32 cases where antibiotics were indicated, only 7 (21.9%) were associated with antibiotic errors. CONCLUSION: Incorporating current antibiotics and review of culture data in a preoperative review and template for patients who need a surgical procedure helps guide appropriate antibiotic decision-making and greatly decreases administration of unnecessary antibiotics. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6811173/ http://dx.doi.org/10.1093/ofid/ofz360.962 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Sterling, Stephanie
Decano, Arnold
Fabian, Evelyn
1098. Perioperative Antibiotic Stewardship for Interventional Radiology Cases Improves Antibiotic Decision-Making
title 1098. Perioperative Antibiotic Stewardship for Interventional Radiology Cases Improves Antibiotic Decision-Making
title_full 1098. Perioperative Antibiotic Stewardship for Interventional Radiology Cases Improves Antibiotic Decision-Making
title_fullStr 1098. Perioperative Antibiotic Stewardship for Interventional Radiology Cases Improves Antibiotic Decision-Making
title_full_unstemmed 1098. Perioperative Antibiotic Stewardship for Interventional Radiology Cases Improves Antibiotic Decision-Making
title_short 1098. Perioperative Antibiotic Stewardship for Interventional Radiology Cases Improves Antibiotic Decision-Making
title_sort 1098. perioperative antibiotic stewardship for interventional radiology cases improves antibiotic decision-making
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811173/
http://dx.doi.org/10.1093/ofid/ofz360.962
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