Pharmacy, Health Sciences & Exercise Science
Analysis of Empiric Antimicrobial Prescribing Patterns and the Introduction of Antimicrobial Stewardship Practices in a Student-Run Outreach Clinic
Document Type
Oral Presentation
Location
Indianapolis, IN
Subject Area
Pharmacy, Health Sciences & Exercise Science
Start Date
10-4-2015 8:45 AM
End Date
10-4-2015 10:00 AM
Sponsor
Kendra Damer (Butler University)
Description
Background: The Butler University Community Outreach Pharmacy (BUCOP), a partner of a student-run medical clinic, provides free medications to underserved patients. A prior BUCOP study demonstrated that approximately 43% of antibacterial medications were prescribed inappropriately based on The Sanford Guide 2013. Inappropriate and excessive empiric prescribing has shown to contribute to antimicrobial resistance. Implementing antimicrobial stewardship practices has the potential to improve antimicrobial prescribing and reduce resistance.
Methods: A retrospective chart review was performed on antibacterial, antifungal, and antiviral prescriptions dispensed to adult patients by the BUCOP between April 2012 and August 2014. For every prescription, the medication name, fill date, patient name, and diagnosis were collected. Every dispensed antimicrobial was compared to the recommended medications listed in the most up-to-date published, peer-reviewed therapy guidelines for the prescription's respective diagnosis. Prescriptions were classified as a match if the medication was recommended in the treatment guidelines; otherwise, the prescription was considered a non-match. Infectious disease diagnoses were also quantified using a tally system during the analysis.
Results: One hundred ninety two prescriptions were included for analysis, and 24% of prescriptions were for male patients. The average age of included patients was 45.8 years old at the time of data analysis. Prescriptions matching treatment guideline regimens (71.9%) outnumbered those that did not (28.1%). Of the 54 non-matching prescriptions, 8 (14.8%) were for conditions that did not warrant antimicrobial treatment. Patients had allergies to recommended antimicrobials for 5 (9.3%) non-matching prescriptions. Genitourinary, skin and soft tissue, and respiratory infections were the most commonly treated infections at the clinic. As a result of the most frequently encountered infections, five antibiotic order forms were designed for treatment of vulvovaginal candidiasis, urinary tract infection, bacterial vaginosis, gonorrhea, chlamydia, and skin and soft tissue infections.
Conclusions: Approximately three-fourths of the antimicrobial prescriptions at BUCOP conformed to current therapy guidelines. Overall, BUCOP's formulary contains appropriate medications for treating the most encountered infections. Though a strong majority of antimicrobial prescriptions were empirically adequate, current antimicrobial prescribing practices at BUCOP can still benefit from improvement. Implementation of the designed antibiotic order forms along with other antimicrobial stewardship initiatives may have a positive impact on antimicrobial prescribing at the clinic.
Analysis of Empiric Antimicrobial Prescribing Patterns and the Introduction of Antimicrobial Stewardship Practices in a Student-Run Outreach Clinic
Indianapolis, IN
Background: The Butler University Community Outreach Pharmacy (BUCOP), a partner of a student-run medical clinic, provides free medications to underserved patients. A prior BUCOP study demonstrated that approximately 43% of antibacterial medications were prescribed inappropriately based on The Sanford Guide 2013. Inappropriate and excessive empiric prescribing has shown to contribute to antimicrobial resistance. Implementing antimicrobial stewardship practices has the potential to improve antimicrobial prescribing and reduce resistance.
Methods: A retrospective chart review was performed on antibacterial, antifungal, and antiviral prescriptions dispensed to adult patients by the BUCOP between April 2012 and August 2014. For every prescription, the medication name, fill date, patient name, and diagnosis were collected. Every dispensed antimicrobial was compared to the recommended medications listed in the most up-to-date published, peer-reviewed therapy guidelines for the prescription's respective diagnosis. Prescriptions were classified as a match if the medication was recommended in the treatment guidelines; otherwise, the prescription was considered a non-match. Infectious disease diagnoses were also quantified using a tally system during the analysis.
Results: One hundred ninety two prescriptions were included for analysis, and 24% of prescriptions were for male patients. The average age of included patients was 45.8 years old at the time of data analysis. Prescriptions matching treatment guideline regimens (71.9%) outnumbered those that did not (28.1%). Of the 54 non-matching prescriptions, 8 (14.8%) were for conditions that did not warrant antimicrobial treatment. Patients had allergies to recommended antimicrobials for 5 (9.3%) non-matching prescriptions. Genitourinary, skin and soft tissue, and respiratory infections were the most commonly treated infections at the clinic. As a result of the most frequently encountered infections, five antibiotic order forms were designed for treatment of vulvovaginal candidiasis, urinary tract infection, bacterial vaginosis, gonorrhea, chlamydia, and skin and soft tissue infections.
Conclusions: Approximately three-fourths of the antimicrobial prescriptions at BUCOP conformed to current therapy guidelines. Overall, BUCOP's formulary contains appropriate medications for treating the most encountered infections. Though a strong majority of antimicrobial prescriptions were empirically adequate, current antimicrobial prescribing practices at BUCOP can still benefit from improvement. Implementation of the designed antibiotic order forms along with other antimicrobial stewardship initiatives may have a positive impact on antimicrobial prescribing at the clinic.