Novel Multidisciplinary Approach for Outpatient Antimicrobial Stewardship Using an Emergency Department Follow-Up...

Area of Science:

• Infectious Diseases
• Pharmacology
• Healthcare Management

Background:

• Outpatient antimicrobial stewardship programs (ASPs) are vital for appropriate antimicrobial prescribing.
• Pharmacist-led interventions are effective, but multidisciplinary approaches for emergency department (ED) discharge are less documented.

Purpose of the Study:

• To evaluate the feasibility and impact of a collaborative model between ASP pharmacotherapy specialists and ED nurse practitioners (NPs).
• To manage patients discharged from the ED through a dedicated follow-up center.

Main Methods:

• Retrospective analysis of patients discharged from the ED between January 2018 and June 2019.
• Inclusion criteria based on documented ASP pharmacotherapy specialist inquiries for ED follow-up center NPs.
• Primary outcome: number and types of ASP interventions.

Main Results:

• 1088 patients and 1114 ASP calls were analyzed.
• Urinary tract infections were the most common positive culture source (79%).
• Third-generation cephalosporins were the most frequent antibiotic (20%); 60% of calls resulted in ASP interventions, including correcting drug-bug mismatches (20%).

Conclusions:

• A novel initiative combining ED NPs and ASP pharmacotherapy specialists was successfully implemented in a large healthcare system.
• This multidisciplinary approach demonstrated feasibility and impact in managing ED follow-up care.
• The collaboration facilitated targeted antimicrobial stewardship interventions for discharged patients.