Community-Acquired Pneumonia Pathway Benefits From Pharmacist Involvement
A pharmacist-driven antimicrobial prescribing pathway for patients with nonsevere community-acquired pneumonia has a positive effect on care, according to a poster abstract presented at IDWeek 2021.
The study included 637 patients initiated on the pathway at seven SSM Health Wisconsin hospitals between September 1, 2020, and June 30, 2021.
Under the pathway, patients with suspected nonsevere community-acquired pneumonia were initiated on antibiotics, typically ceftriaxone and azithromycin, by the provider in keeping with guidelines from the Infectious Diseases Society of America. However, pharmacists used defined protocol criteria to make antibiotic interventions for de-escalation, transition from intravenous to oral antibiotics, and duration of therapy.
Among the 637 participants started on the pathway, about half were removed because of prespecified disqualification criteria. Removal occurred most often following infectious disease or pulmonary consultation, antibiotics for an additional infectious indication such as a urinary tract infection, or a change or broadening of antibiotics by the provider.
Among the 320 participants who completed the pathway, pharmacist interventions included intravenous to oral antibiotics for 147 participants, duration of therapy for 145 participants, and de-escalation for 132 participants, according to the abstract.
The 30-day all-cause hospital readmission rate for participants completing the pathway was 7.5%. Among the 3.8% readmitted for respiratory reasons, none were related to pharmacist involvement in the pathway, the researchers reported.
“Pharmacist-provider regional antimicrobial stewardship collaboration has increased from this process,” the researchers wrote.
Sylvain KC, Polenska JA, Levin JM. Evaluating the safety and effectiveness of a non-severe community acquired pneumonia pharmacist pathway. Paper presented at: IDWeek 2021; September 29-October 3, 2021; Virtual