Abstract
Local antimicrobial susceptibility patterns should be considered for antimicrobial therapy decisions. Antibiogram data can guide beta-lactam antibiotic use in the presence of a penicillin allergy, particularly when allergic cross-reactivity among antibiotic agents is unlikely. To evaluate the effect of a multidimensional antimicrobial stewardship intervention to improve antibiogram-driven antibiotic selection for patients with a reported penicillin allergy receiving aztreonam. This historically controlled, quasi-experimental study compared historical aztreonam use with prospective antibiotic selection following a pharmacist-led intervention in patients with a penicillin allergy. The impact of this intervention on aztreonam use, antimicrobial selection, patient allergy profile updates, length of stay, in-hospital mortality, and antibiotic cost savings was assessed. A significant reduction in median days of aztreonam therapy (4.0 vs. 2.0; p = 0.0001) and median days of therapy per 1000 patient days (14.5 vs. 9.3; p = 0.0001) was found in the intervention group. A pharmacist-led antimicrobial stewardship intervention facilitated antibiogram-driven antibiotic therapy while reducing aztreonam use in patients without an anaphylactic ...Continue Reading
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