Pharmacist-Driven MRSA Nasal Surveillance and Vancomycin De-Escalation
Author Information
Author(s): Jessica Dillon, Domenic Vita, Jessica Abrantes-Figueiredo, Dora Wiskirchen
Primary Institution: Saint Francis Hospital and Medical Center
Hypothesis
Does implementing stewardship pharmacist-driven MRSA nasal surveillance increase the use of the test and reduce inappropriate vancomycin use in pneumonia patients?
Conclusion
Implementing a pharmacist-driven MRSA nasal surveillance program can increase the number of MRSA nasal swabs ordered and promote timely de-escalation of vancomycin in pneumonia patients.
Supporting Evidence
- Percentage of MRSA swabs ordered increased from 36.1% to 83.7% with pharmacist intervention.
- The rate of vancomycin de-escalation following a negative MRSA swab increased from 19.7% to 61.2%.
Takeaway
This study shows that having a pharmacist check for MRSA tests helps doctors order the tests more often and stop using a strong antibiotic called vancomycin when it's not needed.
Methodology
A retrospective pre-/post-intervention study comparing MRSA swab ordering and vancomycin de-escalation before and after pharmacist intervention.
Potential Biases
Potential bias due to the single pharmacist's availability and the variability in swab collection by nursing staff.
Limitations
The rate of MRSA swabs collected varied, and only one pharmacist was involved in the intervention, which may have limited the number of patients intervened upon.
Participant Demographics
Adult patients receiving vancomycin therapy for pneumonia.
Statistical Information
P-Value
<0.0001
Statistical Significance
p<0.0001
Digital Object Identifier (DOI)
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