Impact of a pharmacy-driven culture callback protocol on antimicrobial therapy optimization in the emergency...

Timely assessment of cultures for discharged patients from the emergency department (ED) is crucial for quality patient care and safety outcomes. The purpose of this study was to evaluate the efficacy of implementing a standardized pharmacy-driven culture callback protocol on antimicrobial therapy optimization for patients discharged from the ED with positive urine, blood, or sexually transmitted infection (STI) cultures.

To assess the impact of a pharmacy-driven culture callback process on antimicrobial therapy optimization in the ED.

This study was a single-centered, institutional review board-exempt quality improvement project conducted in the ED of an acute care facility. Patients were included if they were at least 18 years old and were discharged from the ED with positive cultures collected for suspected urinary, sexually transmitted, or bloodstream infections. The primary outcome was the percentage of patients receiving optimal therapy after the culture callback was completed. Secondary outcomes included time from culture results to review by nursing or pharmacy, return visits to the ED and admissions within 30 days due to infection, and total pharmacist time spent reviewing cultures.

When assessing 200 cultures, optimal therapy was greater in the postintervention group compared to the preintervention group (49 vs. 33; P = 0.021). Combined optimal and appropriate therapy was greater in the postintervention group (60 vs. 78; P = 0.006). There was no significant difference for other secondary endpoints; however, there was a great amount of time savings for nursing and providers.

This study demonstrated an increase in optimal therapy for urinary and STIs with a pharmacy-driven culture callback protocol.