AI Article Synopsis
- Rising Clostridium difficile and multidrug-resistant infections, alongside a slowdown in new antibiotic development, highlight the need for improved antimicrobial stewardship in organ transplant patients.
- A study conducted in 2013 audited antimicrobial prescribing practices in transplant patients, revealing that 58% received antimicrobials, with 69.9% of those regimens aligning with stewardship guidelines.
- The findings indicate significant benefits when infectious diseases consultations are involved, as it led to more appropriate prescribing practices, and underscored areas for improvement, such as the need for de-escalation and addressing overly broad or prolonged therapies.
Article Abstract
Objective: Rising incidence of Clostridium difficile and multidrug-resistant organisms' infections and a dwindling development of new antimicrobials are an impetus for antimicrobial stewardship in organ transplant recipients. We sought to understand antimicrobial prescribing practices and identify opportunities for interdisciplinary collaboration among the transplant, antimicrobial stewardship, and infectious diseases teams.
Methods: In 2013, two assessors conducted four real-time audits on all antimicrobial therapy in transplant patients, assessing each regimen against stewardship principles established by the Centers for Disease Prevention and Control, supplemented by applicable transplant-specific infection guidelines. Chi-square test was used to compare stewardship-concordant and stewardship-discordant audit results relative to transplant infectious diseases consultation.
Results: Analysis was performed on 176 audits. Fifty-eight percent (103/176) received at least one antimicrobial, of which 69.9% (72/103) were stewardship-concordant. Infections were confirmed or suspected in 52.3% (92/176). Of those, 98.9% (91/92) received antimicrobials, and 41.8% (38/91) were prescribed by transplant clinicians. Infectious diseases consultation was associated with more stewardship-concordant prescriptions (78.5% vs. 59.6%, p = 0.03). The most common stewardship-discordant categories were lack of de-escalation, empiric antimicrobial spectrum being too broad, and therapy duration being too long.
Conclusions: Opportunities exist for antimicrobial stewardship in transplant recipients, especially those who do not require infectious diseases consultation.
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| http://dx.doi.org/10.1111/ctr.12733 | DOI Listing |
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