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Stewardship: it's going viral.

Abigail Jenkins1, Jubeyr Ahmed2, Andrew Bosworth2

  • 1Department of Pharmacy, University Hospitals Birmingham Foundation Trust, Birmingham, United Kingdom.

Infection Prevention in Practice
|April 1, 2024
PubMed
Summary
This summary is machine-generated.

Antiviral stewardship (AVS) rounds significantly reduced intravenous aciclovir use by 50% during a UK supply shortage. This novel approach optimizes antiviral prescribing and patient management, with plans for wider implementation.

Keywords:
AciclovirAntimicrobialAntiviralStewardship

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Area of Science:

  • Virology
  • Infectious Diseases
  • Clinical Pharmacy

Background:

  • Antimicrobial stewardship (AMS) traditionally focuses on antibiotics, with growing interest in antifungals, but limited development in antiviral stewardship (AVS).
  • A critical UK supply issue with intravenous aciclovir (ACV IV) in June 2022 necessitated urgent measures to conserve the drug.
  • University Hospitals Birmingham (UHBFT) introduced a novel antiviral stewardship review process to manage ACV IV supply.

Purpose of the Study:

  • To describe the implementation and impact of antiviral stewardship (AVS) reviews at UHBFT.
  • To assess the effectiveness of AVS in managing aciclovir (ACV) supply shortages.
  • To evaluate the role of AVS in optimizing antiviral prescribing, diagnostics, and patient management.

Main Methods:

  • A specialist review was implemented for patients receiving >48 hours of ACV IV during a supply shortage.
  • Data collected included advice offered, acceptance rates, and time commitment for the review process.
  • The review focused on preserving ACV IV for critical cases and exploring oral switch or discontinuation.

Main Results:

  • Antiviral stewardship (AVS) rounds halved intravenous aciclovir (ACV IV) consumption by over 50% compared to baseline.
  • More than half of reviewed patients were advised to stop or switch to oral aciclovir therapy.
  • Stewardship advice was readily accepted by clinical teams, and the program was re-introduced due to its success.

Conclusions:

  • Antiviral AMS rounds are effective in optimizing antiviral sampling, diagnosis, and patient management.
  • The established AVS program at UHBFT successfully managed drug supply issues and improved prescribing.
  • The AVS model shows promise for implementation in other healthcare settings to enhance antiviral care.