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Implementation of MRSA Nasal Swabs as an Antimicrobial Stewardship Intervention to Decrease Anti-MRSA Therapy in
Alaina DeKerlegand1, Emily Johnston2, Britney Mellor2
1Pharmacy Department, Methodist University Hospital, Memphis, TN 38104, USA.
Antibiotics (Basel, Switzerland)
|February 25, 2023
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) nasal swab PCR testing effectively reduced anti-MRSA therapy in COVID-19 patients. This antimicrobial stewardship tool helped discontinue or avoid MRSA treatment in 81% of cases.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Limited data existed for antimicrobial stewardship in early SARS-CoV-2 treatment.
- Superimposed bacterial pneumonia was a concern in COVID-19 patients.
Purpose of the Study:
- To evaluate the impact of MRSA nasal swab PCR testing on anti-MRSA therapy de-escalation.
- To assess the utility of MRSA nasal swab PCR as a stewardship tool in COVID-19.
Main Methods:
- Retrospective study at an academic medical center.
- Inclusion of 122 COVID-19 patients between April and July 2020.
- Implementation of MRSA nasal swab PCR testing to guide therapy.
Main Results:
- Anti-MRSA therapy was discontinued in 47.5% and avoided in 33.6% of patients.
- Overall reduction in anti-MRSA therapy observed in 81% of patients.
- MRSA identified in sputum cultures in only three patients, all continued therapy.
Conclusions:
- MRSA nasal swab PCR testing significantly reduced anti-MRSA therapy in COVID-19 patients.
- The testing serves as an effective antimicrobial stewardship intervention.
- Negative swabs facilitated de-escalation, while positive swabs or alternative indications supported continued therapy.
