Background: Studies have shown improvement in the outcome of blood stream infections (BSI) due to the use of Rapid PCR-Based Blood Culture Identification Panel (BCID) in Antimicrobial stewardship programs (ASP). There is currently no data on the use of BCID with ASP in the United Arab Emirates (UAE). Method: Pre-post quasiexperimental study included hospitalized patients with BSI, their positive blood cultures on BCID were studied in 2 groups: conventional culture with ASP (AS), and BCID with ASP (BCID). The primary outcomes were time to first appropriate antimicrobial therapy, infection related length of stay (LOS), ICU admission, 14 days bacteremia recurrence and in-hospital mortality. Secondary outcomes were 30 days reinfection rate, hospital cost and ASP interventions. Results: Out of total 477 positive blood cultures, 206 (AS and BCID) with real BSI were included. The time needed for organism identification was shorter in the BCID group than in the AS group (1.3 h vs. 51 h; P = 0.0002). BCID had a shorter time to appropriate antimicrobial therapy than AS (17.8 h vs.45 h; P = 0.0004). No statistical difference was observed in mortality rate, 14 days bacteremia recurrence, ICU admission, hospital cost, LOS or ASP interventions. Conclusion: Implementing BCID to ASP significantly decreased the time needed to identify the organism and time to appropriate antimicrobial therapy. Similarly, LOS and hospital cost were reduced, however, the reduction was not statistically significant.

Background Although penicillin allergy is commonly reported, less than 1% of the population are truly allergic to penicillin. False penicillin allergy labelling may be associated with suboptimal antibiotic selection, greater costs, and higher prevalence of antibiotic-resistant organisms. The purpose of this study was to evaluate outcomes of implementing a pharmacist-led penicillin-allergy screening protocol on the antibiotic prescribing habits and the appropriateness of selecting first line antimicrobial therapy. Methods A retrospective, quasi-experimental study included 97 patients with suspected or confirmed common infections. Data was collected between January 2020 to August 2021 for the pre-protocol implementation group (PPG) and between November 2021 to April 2022 for the post-protocol implementation group (PPI). Adults ( > 18 years) with a documented penicillin allergy were included. Patients with penicillin allergy were identified and interviewed by our Emergency Department (ED) clinical pharmacists using an evidence-based algorithm. Data were analyzed using two-sample Student’s t-test and descriptive statistics. Results Fifty-one patients in PPG and 46 in PPI. In the PPG, 60.8% (31/51) had a history of beta-lactam tolerance and 26% (8/31) tolerated at least a penicillin derivative previously. While, twenty-two patients (47.8%) in the PPI tolerated beta-lactams and 50% (11/22) tolerated at least one penicillin derivative. Thirty-eight patients (82.6%) had a documented infection in the PPI and received an antibiotic. The use of Moxifloxacin was significantly lower in the PPI vs the PPG, 0% (0/38) vs 17.6 (9/51) respectively, (P=0.008). However, the use of ciprofloxacin, vancomycin, and aztreonam was lower in the PPI vs the PPG but was not statistically significant (Table 2). Antibiotic therapy appropriateness was higher in the PPI as compared to the PPG, 86.8% (33/38) vs 49% (25/51) respectively, (P=0.0004). In the PPI, documented penicillin allergies were delabeled in 23.9% (11/46) of patients. Conclusion We observed higher rates of appropriate first line antibiotic therapy selection post-implementation of the pharmacist led penicillin allergy screening protocol. This could be an effective strategy to optimize antimicrobial therapy in the hospital setting. Disclosures All Authors: No reported disclosures.

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Background: Patients admitted for Heart Failure (HF) are optimally managed through a dedicated multidisciplinary team. Contributions of such team result in better management during admission, intensive patient education, and closer follow-up upon discharge. The 2013 ACC/AHA guidelines recommend such disease management programs and a follow-up visit within 7 to 14 days after discharge. At our institution, a specialized multidisciplinary inpatient HF and transplant service was initiated on January 1, 2017. Methods: A retrospective chart review was conducted to identify patients admitted with a diagnosis of HF from April 1, 2015 to April 1, 2017. Patients admitted prior to starting the service (group 1) were compared to those admitted after the service (group 2). The two groups were compared for changes in renal function and weight between admission and discharge as well as the need for ICU admission, inotrope use, evidence-based discharge medications, length of stay, days to follow-up appointment, 30-day readmission and mortality. Chi-square and t-test comparisons were performed to compare the two groups. Results: A total of 100 (58% with HFrEF) and 60 (65% with HFrEF) patients were identified in group 1 and group 2 respectively. The average length of stay was significantly shorter in the time period after starting the HF service (13.6 ± 21.3 vs 6.8 ± 5.9 days, P < .05); less patients required ICU transfer (29% vs 15%, P < .05) and less patients were readmitted within 30 days following discharge (26% vs 7.1%, P < .05). Additionally, more patients discharged by the HF service were seen within 14 days of discharge (40.2% vs 77.1%, P < .001) with an average follow up of 25.9 ± 36.8 vs 9.9 ± 5.5 days, P < .001. Changes in weight and renal function were not significantly different between the two groups, and so was the use of evidence based medications for HFrEF upon discharge with a trend towards more beta blocker use in group 2. Conclusions: For patients admitted with decompensated HF, a dedicated HF inpatient service is effective in reducing length of stay, ensuring timely follow-up after discharge, and reducing readmissions.