Hospital pharmacists take time out for antimicrobial stewardship.

Abstract

Hospitals large and small are exploring pharmacy-managed antimicrobial therapy “time-outs” as part of antimicrobial stewardship strategies. In Illinois, four Northwestern Medicine hospitals—333-bed Central DuPage Hospital in Winfield, 159-bed Delnor in Geneva, 98-bed Kishwaukee in DeKalb, and 24-bed Valley West in Sandwich—recently presented findings from a study of pharmacist-led antimicrobial therapy time-outs, as did 650-bed University of Nebraska Medical Center in Omaha. The results of the two studies were presented at the October 2016 IDWeek conference in New Orleans. An antimicrobial therapy time-out, according to the Centers for Disease Control and Prevention’s (CDC’s) core elements for hospital antimicrobial stewardship programs, is a systemic evaluation, at a set time point, of the need to continue antimicrobial treatment. Although CDC recommends that hospitals adopt a policy of routinely requiring a time-out 48 hours after the initiation of antimicrobial therapy, that timing isn’t always practical. “It takes about 72 hours to turn around our cultures,” said Radhika Polisetty, clinical and infectious diseases pharmacist at Central DuPage Hospital. Thus, for their study, the pharmacists at the four Northwestern Medicine hospitals performed time-outs 72 hours after initiating therapy so that their recommendations were backed by microbiology test results.