Repurposing antimicrobial stewardship tools in the electronic medical record for the management of COVID-19 patients

Davis, Matthew W.; McManus, Dayna; Koff, Alan; Jaszczur, Gregory R.; Malinis, Maricar; Cruz, Charles S. Dela; Britto, Clemente J.; Price, Christina; Azmy, Veronica; Kaman, Kelsey; Gaston, David C; Early, Kevin T.; DeWitt, Michelle; Song, Jianzheng; Ortíz, Claudia Patricia; Juthani‐Mehta, Manisha; Topal, Jeffrey

doi:10.1017/ice.2020.281

Cited by 13 publications

(14 citation statements)

References 6 publications

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“…15 Similarly, 2 other ASPs utilized flags and other EHR tools to identify which COVID-19 patients would most benefit from ID consultation, a resource that became increasingly strained as hospital censuses rapidly increased. 21,22 The severe morbidity and mortality seen in COVID-19 patients prompted an unprecedented use of antimicrobial agents, both within and outside clinical trials. Given the initial limited supply of medications thought to show antiviral activity against SARS-CoV-2 and uncertainty around which patients would benefit the most from their use, ASP teams applied their expertise to the development of COVID-19 therapeutic guidelines, and they helped allocate these limited resources.…”

Section: Impact Of Asps On the Covid-19 Pandemicmentioning

confidence: 99%

Leveraging antimicrobial stewardship programs in response to the coronavirus disease 2019 (COVID-19) public health emergency

Joerger

Bio

Puckett

et al. 2022

ASHE

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Section: Impact Of Asps On the Covid-19 Pandemicmentioning

confidence: 99%

Leveraging antimicrobial stewardship programs in response to the coronavirus disease 2019 (COVID-19) public health emergency

Joerger

Bio

Puckett

et al. 2022

ASHE

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“…Three research domains identified below (Supplemental Table 4) represent priority areas with unanswered questions concerning antimicrobial stewardship in healthcare settings: presumptively receive antibiotics to treat the potential that the infection is bacterial or that a superimposed bacterial infection is leading to a greater severity of COVID-19. [93][94][95] Similarly, changes in the volume of healthcare access (decreased hospitalizations and outpatient visits) during the pandemic will limit longitudinal comparisons due to altered denominators for typical use metrics, patient bed-days of care (for acute care) and in-person visits (for outpatient care).…”

Section: Antimicrobial Stewardshipmentioning

confidence: 99%

“…Although a decrease in the number of admitted patients may lead to a reduction in overall antimicrobial use, several studies have suggested a large percentage of COVID-19 patients presumptively receive antibiotics to treat the potential that the infection is bacterial or that a superimposed bacterial infection is leading to a greater severity of COVID-19. [93][94][95] Similarly, changes in the volume of healthcare access (decreased hospitalizations and outpatient visits) during the pandemic will limit longitudinal comparisons due to altered denominators for typical use metrics, patient bed days of care (for acute care), and in-person visits (for outpatient care). Additionally, with routine pediatric care transitioning to predominantly telehealth visits, the pandemic's impact on outpatient antibiotic prescribing practices for children remain unexamined (Supplementary Table 5 online).…”

Section: Antimicrobial Stewardshipmentioning

confidence: 99%

Coronavirus disease 2019 (COVID-19) research agenda for healthcare epidemiology

Mody

Akinboyo

Babcock

et al. 2021

Infect. Control Hosp. Epidemiol.

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This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to COVID-19 with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplemental materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical.

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“… 7 , 10 , 11 The established overuse of antimicrobials in this patient population emphasizes the need for antimicrobial stewardship intervention, and application of fundamental stewardship strategies to patients with COVID-19 have been previously described. 12–17 …”

Section: Introductionmentioning

confidence: 99%

A retrospective antibiotic prescribing assessment and examination of potential antibiotic stewardship targets in patients with COVID-19

Stevens

Jensen

Kooda

et al. 2021

JAC-Antimicrobial Resistance

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Objectives Despite low rates of bacterial coinfection in patients admitted with COVID-19, antimicrobials are frequently prescribed. Our primary objective was to evaluate antimicrobial prescribing over time in patients admitted with COVID-19. The secondary objectives were to evaluate the role of ID providers in antimicrobial utilization, describe the rate of confirmed bacterial infection and determine factors associated with empirical antimicrobial prescribing in COVID-19. Materials and methods Retrospective review was performed for adult patients admitted to a tertiary care centre with COVID-19 between 1 March 2020 and 30 November 2020. Patient demographics, disease severity, risk factors for severe disease, clinical outcomes, antimicrobial prescribing and respiratory microbiological testing were collected and analysed. Prescribing trends were evaluated by month, and factors contributing to prescribing were established using univariate and multivariable analysis. Results Antibiotics were prescribed during admission in 37.9% of the study cohort, with 85.1% of patients who received antibiotics having therapy initiated within 48 h of admission. Antibiotic prescribing incidence increased with disease. Over the study period, antimicrobial prescribing rates decreased by 8.7% per month. Multivariable analysis found ICU admission, obtainment of procalcitonin values, intubation, heart failure, haemodialysis and nursing home residence were associated with empirical antimicrobial prescribing. Conclusions Unnecessary antimicrobial prescribing in patients with viral syndromes like COVID-19 continues to represent an area of concern. Antimicrobial stewardship efforts during COVID-19 should consider patient-specific factors associated with antibiotic prescribing. Recognition of such factors, in combination with application of well-established antimicrobial stewardship tactics, may serve to impact antimicrobial prescribing trends, even as patient volumes rise.

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Repurposing antimicrobial stewardship tools in the electronic medical record for the management of COVID-19 patients

Cited by 13 publications

References 6 publications

Leveraging antimicrobial stewardship programs in response to the coronavirus disease 2019 (COVID-19) public health emergency

Leveraging antimicrobial stewardship programs in response to the coronavirus disease 2019 (COVID-19) public health emergency

Coronavirus disease 2019 (COVID-19) research agenda for healthcare epidemiology

A retrospective antibiotic prescribing assessment and examination of potential antibiotic stewardship targets in patients with COVID-19

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