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Open AccessArticle

Pharmacist-Driven Culture and Sexually Transmitted Infection Testing Follow-Up Program in the Emergency Department

1
Department of Pharmacy, Prisma Health Richland Hospital, Columbia, SC 29203, USA
2
Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, SC 29208, USA
3
Department of Medicine, University of South Carolina School of Medicine, Columbia, SC 29209, USA
4
Emergency Department, Prisma Health Richland Hospital, Columbia, SC 29203, USA
*
Author to whom correspondence should be addressed.
Pharmacy 2020, 8(2), 72; https://doi.org/10.3390/pharmacy8020072
Received: 11 March 2020 / Revised: 19 April 2020 / Accepted: 21 April 2020 / Published: 23 April 2020
(This article belongs to the Special Issue Antimicrobial Stewardship across the Continuum of Care)
Expanding pharmacist-driven antimicrobial stewardship efforts in the emergency department (ED) can improve antibiotic management for both admitted and discharged patients. We piloted a pharmacist-driven culture and rapid diagnostic technology (RDT) follow-up program in patients discharged from the ED. This was a single-center, pre- and post-implementation, cohort study examining the impact of a pharmacist-driven culture/RDT follow-up program in the ED. Adult patients discharged from the ED with subsequent positive cultures and/or RDT during the pre- (21 August 2018–18 November 2018) and post-implementation (19 November 2018–15 February 2019) periods were screened for inclusion. The primary endpoints were time from ED discharge to culture/RDT review and completion of follow-up. Secondary endpoints included antimicrobial agent prescribed during outpatient follow-up, repeat ED encounters within 30 days, and hospital admissions within 30 days. Baseline characteristics were analyzed using descriptive statistics. Time-to-event data were analyzed using the Wilcoxon signed-rank test. One-hundred-and-twenty-seven patients were included, 64 in the pre-implementation group and 63 in the post-implementation group. There was a 36.3% reduction in the meantime to culture/RDT data review in the post-implementation group (75.2 h vs. 47.9 h, p < 0.001). There was a significant reduction in fluoroquinolone prescribing in the post-implementation group (18.1% vs. 5.4%, p = 0.036). The proportion of patients who had a repeat ED encounter or hospital admission within 30 days was not significantly different between the pre- and post-implementation groups (15.6 vs. 19.1%, p = 0.78 and 9.4% vs. 7.9%, p = 1.0, respectively). Introduction of a pharmacist culture and RDT follow-up program in the ED reduced time to data review, time to outpatient intervention and outpatient follow-up of fluoroquinolone prescribing. View Full-Text
Keywords: pharmacy resident; rapid diagnostic technology; urinary tract infections; antimicrobial stewardship pharmacy resident; rapid diagnostic technology; urinary tract infections; antimicrobial stewardship
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Shealy, S.C.; Alexander, C.; Hardison, T.G.; Magagnoli, J.; Justo, J.A.; Derrick, C.; Kohn, J.; Winders, H.R.; Privette, T.; Al-Hasan, M.N.; Bookstaver, P.B. Pharmacist-Driven Culture and Sexually Transmitted Infection Testing Follow-Up Program in the Emergency Department. Pharmacy 2020, 8, 72.

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