NEW ORLEANS — Patients with bacterial pneumonia in an intensive care unit (ICU) experienced shorter hospital stays and required fewer days of antibiotic therapy after the implementation of a pharmacist-driven treatment protocol, according to research presented at IDWeek 2016.

Maureen Campion, PharmD, of Franciscan St. Francis Health in Indianapolis, Indiana, and colleagues conducted a retrospective review of patients hospitalized in an ICU with a pneumonia diagnosis between 2014 and 2016. Patients were divided into 2 cohorts; data collected and compared included baseline characteristics, number of days of antibiotic therapy, length of ICU stay, length of hospital stay, mortality, and 30-day readmission rates.

A total of 201 patients were included in the review (pre-intervention control group n=134, intervention group n=67). Dr Campion and colleagues found that while baseline characteristics were similar between groups, patients in the intervention group required, on average, fewer days of therapy (12.31±6.54 days vs 15.88±6.93 days, P <.001). Additionally, patients in the pre-intervention group were more likely to receive >7 days of antibiotic treatment (odds ratio [OR]: 3.7; 95% confidence interval [CI], 1.5-9.0).


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The researchers did not identify differences in mortality, length of ICU stay, overall length of stay, or 30-day readmission between the two groups.

The strengths of this study are that it mirrored a true practice in a high acuity unit.  However, the study was limited in that information was available for only 3 months of protocol implementation, the protocol was limited to trained pharmacists, and the researchers were unable to show a statistical difference in days of antibiotic therapy.

“Bacterial pneumonia…is associated with increased costs and an average length of stay of 5.2 days,” the researchers noted. “Current literature regarding community-acquired and hospital-acquired pneumonia indicates that longer antimicrobial therapy does not improve clinical or microbiological outcomes.”

“Implementation of a pharmacist-driven protocol for treatment of pneumonia in a medical ICU reduced days of antibiotic therapy without increasing length of stay or mortality in this single-center study,” Dr Campion and colleagues concluded.

Reference

Campion M, Sponsel K, Stock AH, Shawa I, Need R, Cheatham SC. Optimization of pneumonia treatment in an intensive care unit utilizing a pharmacist-driven protocol. Presented at: ID Week 2016; October 26-30, 2016; New Orleans, LA. Abstract 908.