A Needs Assessment for Infectious Diseases Consultation in Community Hospitals

Area of Science:

• Infectious Diseases
• Antimicrobial Stewardship
• Rural Health

Background:

• Infectious diseases (ID) consultations improve outcomes for severe infections.
• Rural communities often lack access to ID specialists.
• Outcomes in rural hospitals without ID coverage are understudied.

Purpose of the Study:

• Characterize patient outcomes in community hospitals lacking ID physician coverage.
• Identify opportunities for improving antimicrobial therapy and stewardship in rural settings.

Main Methods:

• Retrospective assessment of 3706 adult patients at 8 community hospitals without ID consultation.
• Analysis of patients receiving at least 3 days of continuous antimicrobial therapy.
• Evaluation of antimicrobial regimens by board-certified ID physicians.

Main Results:

• Only 0.01% of patients required transfer for ID consultation.
• ID physicians would have modified regimens in 68.5% of cases.
• Identified areas for improvement include COPD exacerbations, SSTI, azithromycin use, and S. aureus bacteremia management.

Conclusions:

• Patient transfers for ID consultation are infrequent in rural hospitals.
• Significant opportunities exist to optimize antimicrobial regimens and stewardship.
• Expanding ID workforce coverage to rural areas may improve antibiotic utilization.