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Evaluation of a Pharmacist-Led Methicillin-Resistant Staphylococcus aureus Nasal PCR Testing Protocol
Blain Thayer1, Jonathan D Edwards2, Madeline G Belk2
1Missouri Health University Hospital, Columbia, MO 65212, USA.
Antibiotics (Basel, Switzerland)
|January 8, 2025
Summary
Pharmacists ordering methicillin-resistant Staphylococcus aureus (MRSA) nasal PCR tests reduced vancomycin use and hospital stays for pneumonia patients. This protocol improved patient outcomes by enabling targeted antimicrobial therapy based on negative MRSA PCR results.
Area of Science:
- Infectious Diseases
- Clinical Pharmacy
- Health Outcomes Research
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of various pneumonia types.
- Nasal colonization with MRSA increases infection risk.
- MRSA nasal PCR tests have high negative predictive value, supporting antimicrobial de-escalation.
Purpose of the Study:
- To evaluate the effectiveness of a protocol enabling pharmacists to order MRSA nasal PCR screenings.
- To assess the impact of pharmacist-led MRSA PCR testing on patient care and outcomes in pneumonia cases.
Main Methods:
- Retrospective chart review comparing pre- and post-protocol implementation cohorts.
- Protocol allowed pharmacists to order MRSA nasal PCR tests for pneumonia patients.
- Primary endpoint: Vancomycin days of therapy (DOTs); secondary endpoints: hospitalization length, readmission rates, mortality.
Main Results:
- Pharmacist-ordered MRSA nasal PCRs significantly reduced vancomycin DOTs.
- Average length of hospital stay and 30-day readmission rates were significantly lower post-protocol.
- No significant difference in mortality was observed between groups.
Conclusions:
- Pharmacist-initiated MRSA nasal PCR testing is effective in reducing vancomycin utilization.
- The protocol led to shorter hospitalizations and decreased readmission rates.
- This strategy optimizes antimicrobial stewardship and improves patient outcomes in pneumonia management.
