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Published in: Current Infectious Disease Reports 12/2023

20-11-2023 | Antibiotic | Antimicrobial Development and Drug Resistance (KC Claeys and J Smith, Section Editors)

Antibiotic Use at Hospital Discharge and Outpatient Antimicrobial Stewardship

Authors: Mandee Noval, Colleen Burgoyne, Jacinta Chin, Kathryn Dzintars, Aileen Jimenez, Angela Perhac, Jessa Brenon

Published in: Current Infectious Disease Reports | Issue 12/2023

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Abstract

Purpose of Review

Inappropriate and unnecessary antibiotic prescriptions are common in the outpatient setting and as patients transition from inpatient to outpatient care. This review is designed to discuss effective strategies aimed to improve appropriate antibiotic use during transitions of care and in the outpatient setting for high-priority syndrome areas including acute respiratory infections (ARI), urinary tract infections (UTI), skin and soft tissue infections (SSTI), and bone and joint infections (BJI).

Recent Findings

Unlike inpatient stewardship programs, outpatient stewardship practices are currently not standardized across many healthcare systems. Since starting an outpatient ASP can be overwhelming, many programs opt to start by focusing on a smaller subset of high-priority locations or syndromes where antibiotics may be inappropriately prescribed. Numerous studies have identified effective antimicrobial stewardship strategies that can be incorporated on transitions of care and in the outpatient setting; however, a multimodal approach combining several stewardship strategies is often cited as the most effective approach. Available syndrome-specific interventions include opportunities at time of diagnosis, order entry, and post-prescription which may be tailored to meet individual program needs.

Summary

Outpatient ASP interventions targeted at diagnostic stewardship, adjustments to duration of therapy, optimization of agent selection, and avoidance of intravenous therapy remain high-priority target areas to prevent inappropriate antibiotic use.
Literature
1.
go back to reference Fishman N, America S for HE of, America IDS of, Society PID. Policy Statement on Antimicrobial Stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS). Infect Control Hosp Epidemiol. 2012;33(4):322–7. Fishman N, America S for HE of, America IDS of, Society PID. Policy Statement on Antimicrobial Stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS). Infect Control Hosp Epidemiol. 2012;33(4):322–7.
3.
go back to reference Tamma PD, Avdic E, Li DX, Dzintars K, Cosgrove SE. Association of adverse events with antibiotic use in hospitalized patients. JAMA Intern Med. 2017;177(9):1308–15.PubMedPubMedCentralCrossRef Tamma PD, Avdic E, Li DX, Dzintars K, Cosgrove SE. Association of adverse events with antibiotic use in hospitalized patients. JAMA Intern Med. 2017;177(9):1308–15.PubMedPubMedCentralCrossRef
5.
go back to reference Shehab N, Patel PR, Srinivasan A, Budnitz DS. Emergency department visits for antibiotic-associated adverse events. Clin Infect Dis Off Publ Infect Dis Soc Am. 2008;47(6):735–43.CrossRef Shehab N, Patel PR, Srinivasan A, Budnitz DS. Emergency department visits for antibiotic-associated adverse events. Clin Infect Dis Off Publ Infect Dis Soc Am. 2008;47(6):735–43.CrossRef
6.
go back to reference Barlam TF, Cosgrove SE, Abbo LM, MacDougall C, Schuetz AN, Septimus EJ, et al. Implementing an Antibiotic Stewardship Program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis. 2016;62(10):e51–77.PubMedPubMedCentralCrossRef Barlam TF, Cosgrove SE, Abbo LM, MacDougall C, Schuetz AN, Septimus EJ, et al. Implementing an Antibiotic Stewardship Program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis. 2016;62(10):e51–77.PubMedPubMedCentralCrossRef
9.
go back to reference Fleming-Dutra KE, Hersh AL, Shapiro DJ, Bartoces M, Enns EA, File TM Jr, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA. 2016;315(17):1864–73.PubMedCrossRef Fleming-Dutra KE, Hersh AL, Shapiro DJ, Bartoces M, Enns EA, File TM Jr, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA. 2016;315(17):1864–73.PubMedCrossRef
10.
go back to reference Marcelin JR, Chung P, Schooneveld TCV. Antimicrobial stewardship in the outpatient setting: a review and proposed framework. Infect Control Hosp Epidemiol. 2020;41(7):833–40.PubMedCrossRef Marcelin JR, Chung P, Schooneveld TCV. Antimicrobial stewardship in the outpatient setting: a review and proposed framework. Infect Control Hosp Epidemiol. 2020;41(7):833–40.PubMedCrossRef
11.
go back to reference Durkin MJ, Keller M, Butler AM, Kwon JH, Dubberke ER, Miller AC, et al. An assessment of inappropriate antibiotic use and guideline adherence for uncomplicated urinary tract infections. Open Forum Infect Dis. 2018;5(9):ofy198. Durkin MJ, Keller M, Butler AM, Kwon JH, Dubberke ER, Miller AC, et al. An assessment of inappropriate antibiotic use and guideline adherence for uncomplicated urinary tract infections. Open Forum Infect Dis. 2018;5(9):ofy198.
12.
go back to reference • Cawcutt KA, Patel R, Gerber J, Caliendo AM, Cosgrove SE, Ashley ED, et al. Leveraging existing and soon-to-be-available novel diagnostics for optimizing outpatient antibiotic stewardship in patients with respiratory tract infections. Clin Infect Dis Off Publ Infect Dis Soc Am. 2021;72(12):e1115–21. This is an excellent review on the currently available rapid diagnostic tests available for use in the diagnosis of respiratory tract infections that may be useful in ARI management. The article discusses different considerations based on testing platform and where they may fit into patient care. • Cawcutt KA, Patel R, Gerber J, Caliendo AM, Cosgrove SE, Ashley ED, et al. Leveraging existing and soon-to-be-available novel diagnostics for optimizing outpatient antibiotic stewardship in patients with respiratory tract infections. Clin Infect Dis Off Publ Infect Dis Soc Am. 2021;72(12):e1115–21. This is an excellent review on the currently available rapid diagnostic tests available for use in the diagnosis of respiratory tract infections that may be useful in ARI management. The article discusses different considerations based on testing platform and where they may fit into patient care.
13.
go back to reference May L, Sickler J, Robbins EM, Tang S, Chugh K, Tran N. The impact of point-of-care polymerase chain reaction testing on prescribing practices in primary care for management of strep A: a retrospective before–after study. Open Forum Infect Dis. 2022;9(5):ofac147. May L, Sickler J, Robbins EM, Tang S, Chugh K, Tran N. The impact of point-of-care polymerase chain reaction testing on prescribing practices in primary care for management of strep A: a retrospective before–after study. Open Forum Infect Dis. 2022;9(5):ofac147.
14.
go back to reference Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis Off Publ Infect Dis Soc Am. 2012;55(10):e86–102.CrossRef Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis Off Publ Infect Dis Soc Am. 2012;55(10):e86–102.CrossRef
15.
go back to reference Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45–67. Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45–67.
16.
go back to reference Andrade A, Bang H, Reddick K, Villaseñor B, Tran NK, May L. Evaluation of pharmacist guided intervention using procalcitonin and respiratory virus testing. Am J Emerg Med. 2023;66:146–51.PubMedPubMedCentralCrossRef Andrade A, Bang H, Reddick K, Villaseñor B, Tran NK, May L. Evaluation of pharmacist guided intervention using procalcitonin and respiratory virus testing. Am J Emerg Med. 2023;66:146–51.PubMedPubMedCentralCrossRef
17.
go back to reference Huang DT, Yealy DM, Filbin MR, Brown AM, Chang CCH, Doi Y, et al. Procalcitonin-guided use of antibiotics for lower respiratory tract infection. N Engl J Med. 2018;379(3):236–49.PubMedPubMedCentralCrossRef Huang DT, Yealy DM, Filbin MR, Brown AM, Chang CCH, Doi Y, et al. Procalcitonin-guided use of antibiotics for lower respiratory tract infection. N Engl J Med. 2018;379(3):236–49.PubMedPubMedCentralCrossRef
18.
go back to reference Schuetz P, Christ-Crain M, Thomann R, Falconnier C, Wolbers M, Widmer I, et al. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial. JAMA. 2009;302(10):1059–66.PubMedCrossRef Schuetz P, Christ-Crain M, Thomann R, Falconnier C, Wolbers M, Widmer I, et al. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial. JAMA. 2009;302(10):1059–66.PubMedCrossRef
19.
go back to reference Dyer AP, Dodds Ashley E, Anderson DJ, Sarubbi C, Wrenn R, Hicks LA, et al. Total duration of antimicrobial therapy resulting from inpatient hospitalization. Infect Control Hosp Epidemiol. 2019;40(8):847–54.PubMedCrossRef Dyer AP, Dodds Ashley E, Anderson DJ, Sarubbi C, Wrenn R, Hicks LA, et al. Total duration of antimicrobial therapy resulting from inpatient hospitalization. Infect Control Hosp Epidemiol. 2019;40(8):847–54.PubMedCrossRef
20.
go back to reference Vaughn VM, Hersh AL, Spivak ES. Antibiotic overuse and stewardship at hospital discharge: the reducing overuse of antibiotics at discharge home framework. Clin Infect Dis Off Publ Infect Dis Soc Am. 2021;74(9):1696–702.CrossRef Vaughn VM, Hersh AL, Spivak ES. Antibiotic overuse and stewardship at hospital discharge: the reducing overuse of antibiotics at discharge home framework. Clin Infect Dis Off Publ Infect Dis Soc Am. 2021;74(9):1696–702.CrossRef
21.
go back to reference Hiryak KM, Kludjian GA, Gallagher JC, Cavaretta MJ. Improving antibiotic utilization through an outpatient stewardship initiative. Antimicrob Steward Healthc Epidemiol ASHE. 2023;3(1):e120.PubMed Hiryak KM, Kludjian GA, Gallagher JC, Cavaretta MJ. Improving antibiotic utilization through an outpatient stewardship initiative. Antimicrob Steward Healthc Epidemiol ASHE. 2023;3(1):e120.PubMed
22.
go back to reference Sribenjalux W, Larbsida N, Khamsai S, Panyapornsakul B, Deawtrakulchai P, Meesing A. Insertion of a clinical pathway pop-up window into a computer-based prescription system: a method to promote antibiotic stewardship in upper respiratory tract infection. Antibiotics. 2021;10(12):1479.PubMedPubMedCentralCrossRef Sribenjalux W, Larbsida N, Khamsai S, Panyapornsakul B, Deawtrakulchai P, Meesing A. Insertion of a clinical pathway pop-up window into a computer-based prescription system: a method to promote antibiotic stewardship in upper respiratory tract infection. Antibiotics. 2021;10(12):1479.PubMedPubMedCentralCrossRef
23.
go back to reference Vuong L, Kenney RM, Thomson JM, Faison DJ, Church BM, McCollom R, et al. Implementation of indication-based antibiotic order sentences improves antibiotic use in emergency departments. Am J Emerg Med. 2023;69:5–10.PubMedCrossRef Vuong L, Kenney RM, Thomson JM, Faison DJ, Church BM, McCollom R, et al. Implementation of indication-based antibiotic order sentences improves antibiotic use in emergency departments. Am J Emerg Med. 2023;69:5–10.PubMedCrossRef
24.
go back to reference Goss FR, Bookman K, Barron M, Bickley D, Landgren B, Kroehl M, et al. Improved antibiotic prescribing using indication-based clinical decision support in the emergency department. J Am Coll Emerg Physicians Open. 2020;1(3):214–21.PubMedPubMedCentralCrossRef Goss FR, Bookman K, Barron M, Bickley D, Landgren B, Kroehl M, et al. Improved antibiotic prescribing using indication-based clinical decision support in the emergency department. J Am Coll Emerg Physicians Open. 2020;1(3):214–21.PubMedPubMedCentralCrossRef
25.
go back to reference Foreman BJ, Westerhof L, Benzer J, Eid K, Egwuatu NE, Dumkow LE. Impact of order sentence implementation on outpatient antibiotic prescribing for urinary tract infection and skin and soft tissue infection. JACCP J Am Coll Clin Pharm. 2022;5(3):283–90.CrossRef Foreman BJ, Westerhof L, Benzer J, Eid K, Egwuatu NE, Dumkow LE. Impact of order sentence implementation on outpatient antibiotic prescribing for urinary tract infection and skin and soft tissue infection. JACCP J Am Coll Clin Pharm. 2022;5(3):283–90.CrossRef
26.
go back to reference Meeker D, Linder JA, Fox CR, Friedberg MW, Persell SD, Goldstein NJ, et al. Effect of behavioral interventions on inappropriate antibiotic prescribing among primary care practices: a randomized clinical trial. JAMA. 2016;315(6):562–70.PubMedPubMedCentralCrossRef Meeker D, Linder JA, Fox CR, Friedberg MW, Persell SD, Goldstein NJ, et al. Effect of behavioral interventions on inappropriate antibiotic prescribing among primary care practices: a randomized clinical trial. JAMA. 2016;315(6):562–70.PubMedPubMedCentralCrossRef
27.
go back to reference Mangione-Smith R, Zhou C, Robinson JD, Taylor JA, Elliott MN, Heritage J. Communication practices and antibiotic use for acute respiratory tract infections in children. Ann Fam Med. 2015;13(3):221–7.PubMedPubMedCentralCrossRef Mangione-Smith R, Zhou C, Robinson JD, Taylor JA, Elliott MN, Heritage J. Communication practices and antibiotic use for acute respiratory tract infections in children. Ann Fam Med. 2015;13(3):221–7.PubMedPubMedCentralCrossRef
28.
go back to reference Meeker D, Knight TK, Friedberg MW, Linder JA, Goldstein NJ, Fox CR, et al. Nudging guideline-concordant antibiotic prescribing: a randomized clinical trial. JAMA Intern Med. 2014;174(3):425–31.PubMedPubMedCentralCrossRef Meeker D, Knight TK, Friedberg MW, Linder JA, Goldstein NJ, Fox CR, et al. Nudging guideline-concordant antibiotic prescribing: a randomized clinical trial. JAMA Intern Med. 2014;174(3):425–31.PubMedPubMedCentralCrossRef
31.
go back to reference White AT, Clark CM, Sellick JA, Mergenhagen KA. Antibiotic stewardship targets in the outpatient setting. Am J Infect Control. 2019;47(8):858–63.PubMedCrossRef White AT, Clark CM, Sellick JA, Mergenhagen KA. Antibiotic stewardship targets in the outpatient setting. Am J Infect Control. 2019;47(8):858–63.PubMedCrossRef
32.
go back to reference • Goebel MC, Trautner BW, Grigoryan L. The five Ds of outpatient antibiotic stewardship for urinary tract infections. Clin Microbiol Rev. 2021;34(4):e0000320. This article serves as an excellent review of outpatient ASP practices related to UTI, focusing on tactics to help improve diagnosis, drug selection, dose optimization, duration, and de-escalation. • Goebel MC, Trautner BW, Grigoryan L. The five Ds of outpatient antibiotic stewardship for urinary tract infections. Clin Microbiol Rev. 2021;34(4):e0000320. This article serves as an excellent review of outpatient ASP practices related to UTI, focusing on tactics to help improve diagnosis, drug selection, dose optimization, duration, and de-escalation.
33.
go back to reference Claeys KC, Trautner BW, Leekha S, Coffey KC, Crnich CJ, Diekema DJ, et al. Optimal urine culture diagnostic stewardship practice—results from an expert modified-Delphi procedure. Clin Infect Dis Off Publ Infect Dis Soc Am. 2022;75(3):382–9.CrossRef Claeys KC, Trautner BW, Leekha S, Coffey KC, Crnich CJ, Diekema DJ, et al. Optimal urine culture diagnostic stewardship practice—results from an expert modified-Delphi procedure. Clin Infect Dis Off Publ Infect Dis Soc Am. 2022;75(3):382–9.CrossRef
34.
go back to reference Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis Off Publ Infect Dis Soc Am. 2011;52(5):e103–120.CrossRef Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis Off Publ Infect Dis Soc Am. 2011;52(5):e103–120.CrossRef
35.
go back to reference Eudaley ST, Mihm AE, Higdon R, Jeter J, Chamberlin SM. Development and implementation of a clinical decision support tool for treatment of uncomplicated urinary tract infections in a family medicine resident clinic. J Am Pharm Assoc. 2019;59(4):579–85.CrossRef Eudaley ST, Mihm AE, Higdon R, Jeter J, Chamberlin SM. Development and implementation of a clinical decision support tool for treatment of uncomplicated urinary tract infections in a family medicine resident clinic. J Am Pharm Assoc. 2019;59(4):579–85.CrossRef
36.
go back to reference Zalmanovich A, Katzir M, Chowers M, Matar A, Rodrig J, Alon D. Improving urinary tract infection treatment through a multifaceted antimicrobial stewardship intervention in the emergency department. Am J Emerg Med. 2021;49:10–3.PubMedCrossRef Zalmanovich A, Katzir M, Chowers M, Matar A, Rodrig J, Alon D. Improving urinary tract infection treatment through a multifaceted antimicrobial stewardship intervention in the emergency department. Am J Emerg Med. 2021;49:10–3.PubMedCrossRef
37.
go back to reference Jaggi P, Wang L, Gleeson S, Moore-Clingenpeel M, Watson JR. Outpatient antimicrobial stewardship targets for treatment of skin and soft-tissue infections. Infect Control Hosp Epidemiol. 2018;39(8):936–40.PubMedCrossRef Jaggi P, Wang L, Gleeson S, Moore-Clingenpeel M, Watson JR. Outpatient antimicrobial stewardship targets for treatment of skin and soft-tissue infections. Infect Control Hosp Epidemiol. 2018;39(8):936–40.PubMedCrossRef
38.
go back to reference Westerhof LR, Dumkow LE, Hanrahan TL, McPharlin SV, Egwuatu NE. Outcomes of an ambulatory care pharmacist-led antimicrobial stewardship program within a family medicine resident clinic. Infect Control Hosp Epidemiol. 2021;42(6):715–21.PubMedCrossRef Westerhof LR, Dumkow LE, Hanrahan TL, McPharlin SV, Egwuatu NE. Outcomes of an ambulatory care pharmacist-led antimicrobial stewardship program within a family medicine resident clinic. Infect Control Hosp Epidemiol. 2021;42(6):715–21.PubMedCrossRef
39.
go back to reference Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJC, Gorbach SL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis Off Publ Infect Dis Soc Am. 2014;59(2):e10–52.CrossRef Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJC, Gorbach SL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis Off Publ Infect Dis Soc Am. 2014;59(2):e10–52.CrossRef
40.
go back to reference Stoll K, Feltz E, Ebert S. Pharmacist-driven implementation of outpatient antibiotic prescribing algorithms improves guideline adherence in the emergency department. J Pharm Pract. 2021;34(6):875–81.PubMedCrossRef Stoll K, Feltz E, Ebert S. Pharmacist-driven implementation of outpatient antibiotic prescribing algorithms improves guideline adherence in the emergency department. J Pharm Pract. 2021;34(6):875–81.PubMedCrossRef
41.
go back to reference Kaye KS, Petty LA, Shorr AF, Zilberberg MD. Current epidemiology, etiology, and burden of acute skin infections in the United States. Clin Infect Dis Off Publ Infect Dis Soc Am. 2019;68(Suppl 3):S193–9.CrossRef Kaye KS, Petty LA, Shorr AF, Zilberberg MD. Current epidemiology, etiology, and burden of acute skin infections in the United States. Clin Infect Dis Off Publ Infect Dis Soc Am. 2019;68(Suppl 3):S193–9.CrossRef
42.
go back to reference King LM, Hersh AL, Hicks LA, Fleming-Dutra KE. Duration of outpatient antibiotic therapy for common outpatient infections, 2017. Clin Infect Dis Off Publ Infect Dis Soc Am. 2021;72(10):e663–6.CrossRef King LM, Hersh AL, Hicks LA, Fleming-Dutra KE. Duration of outpatient antibiotic therapy for common outpatient infections, 2017. Clin Infect Dis Off Publ Infect Dis Soc Am. 2021;72(10):e663–6.CrossRef
43.
go back to reference Lee P, Rico M, Muench S, Yost C, Zimmerman LH. Impact of outpatient antimicrobial stewardship guideline implementation in an urgent care setting. J Am Pharm Assoc. 2022;62(6):1792–8.CrossRef Lee P, Rico M, Muench S, Yost C, Zimmerman LH. Impact of outpatient antimicrobial stewardship guideline implementation in an urgent care setting. J Am Pharm Assoc. 2022;62(6):1792–8.CrossRef
44.
go back to reference Hamner M, Nedved A, Austin H, Wyly D, Burns A, Berg K, et al. Improving duration of antibiotics for skin and soft-tissue infections in pediatric urgent cares. Pediatrics. 2022;150(6):e2022057974.PubMedCrossRef Hamner M, Nedved A, Austin H, Wyly D, Burns A, Berg K, et al. Improving duration of antibiotics for skin and soft-tissue infections in pediatric urgent cares. Pediatrics. 2022;150(6):e2022057974.PubMedCrossRef
45.
go back to reference Palit J, Cole J, Durojaiye OC. Clinical and operational factors associated with treatment duration for cellulitis in outpatient parenteral antimicrobial therapy (OPAT). Diagn Microbiol Infect Dis. 2021;100(1):115305.PubMedCrossRef Palit J, Cole J, Durojaiye OC. Clinical and operational factors associated with treatment duration for cellulitis in outpatient parenteral antimicrobial therapy (OPAT). Diagn Microbiol Infect Dis. 2021;100(1):115305.PubMedCrossRef
46.
go back to reference Burgess DR, Baum RA, Bailey A, Myint T, Wallace KL. Impact of an antimicrobial stewardship and emergency department initiated dalbavancin guideline for patients with acute bacterial skin and soft-tissue infections. Open Forum Infect Dis. 2017;4(Suppl 1):S267.PubMedCentralCrossRef Burgess DR, Baum RA, Bailey A, Myint T, Wallace KL. Impact of an antimicrobial stewardship and emergency department initiated dalbavancin guideline for patients with acute bacterial skin and soft-tissue infections. Open Forum Infect Dis. 2017;4(Suppl 1):S267.PubMedCentralCrossRef
47.
go back to reference Mahoney MV, Childs-Kean LM, Khan P, Rivera CG, Stevens RW, Ryan KL. Recent updates in antimicrobial stewardship in outpatient parenteral antimicrobial therapy. Curr Infect Dis Rep. 2021;23(12):24.PubMedPubMedCentralCrossRef Mahoney MV, Childs-Kean LM, Khan P, Rivera CG, Stevens RW, Ryan KL. Recent updates in antimicrobial stewardship in outpatient parenteral antimicrobial therapy. Curr Infect Dis Rep. 2021;23(12):24.PubMedPubMedCentralCrossRef
48.
go back to reference Britt RS, LaSalvia MT, Padival S, Patel P, McCoy C, Mahoney MV. Evaluation of inpatient antimicrobial regimens for readmitted outpatient parenteral antimicrobial therapy patients receiving daptomycin or ertapenem for ease of administration. Open Forum Infect Dis. 2019;6(12):ofz496. Britt RS, LaSalvia MT, Padival S, Patel P, McCoy C, Mahoney MV. Evaluation of inpatient antimicrobial regimens for readmitted outpatient parenteral antimicrobial therapy patients receiving daptomycin or ertapenem for ease of administration. Open Forum Infect Dis. 2019;6(12):ofz496.
49.
go back to reference Britt RS, Pearson JC, LaSalvia MT, Mahoney MV, McCoy C, Padival S. Impact of a pharmacy resident on a transitions of care rotation for inpatients enrolled in an outpatient parenteral antimicrobial therapy (OPAT) program. Antimicrob Steward Healthc Epidemiol ASHE. 2023;3(1):e111.PubMed Britt RS, Pearson JC, LaSalvia MT, Mahoney MV, McCoy C, Padival S. Impact of a pharmacy resident on a transitions of care rotation for inpatients enrolled in an outpatient parenteral antimicrobial therapy (OPAT) program. Antimicrob Steward Healthc Epidemiol ASHE. 2023;3(1):e111.PubMed
50.
go back to reference Oliver NT, Skalweit MJ. Outpatient parenteral antibiotic therapy in older adults. Infect Dis Clin. 2023;37(1):123–37.CrossRef Oliver NT, Skalweit MJ. Outpatient parenteral antibiotic therapy in older adults. Infect Dis Clin. 2023;37(1):123–37.CrossRef
51.
go back to reference Carr JA, Baddley JW, Heath S, Lee RA, McCarty TP. Impact of an antimicrobial stewardship program led OPAT program on clinical complications and frequency of hospital readmissions. Open Forum Infect Dis. 2017;4(Suppl 1):S334–5.PubMedCentralCrossRef Carr JA, Baddley JW, Heath S, Lee RA, McCarty TP. Impact of an antimicrobial stewardship program led OPAT program on clinical complications and frequency of hospital readmissions. Open Forum Infect Dis. 2017;4(Suppl 1):S334–5.PubMedCentralCrossRef
52.
go back to reference Larnard J, Swords K, Taupin D, Padival S. From sea to shining IV: the current state of OPAT in the United States. Ther Adv Infect Dis. 2023;19(10):20499361231181490. Larnard J, Swords K, Taupin D, Padival S. From sea to shining IV: the current state of OPAT in the United States. Ther Adv Infect Dis. 2023;19(10):20499361231181490.
53.
go back to reference Gariani K, Lebowitz D, Kressmann B, von Dach E, Sendi P, Waibel F, et al. Oral amoxicillin-clavulanate for treating diabetic foot infections. Diabetes Obes Metab. 2019;21(6):1483–6.PubMedCrossRef Gariani K, Lebowitz D, Kressmann B, von Dach E, Sendi P, Waibel F, et al. Oral amoxicillin-clavulanate for treating diabetic foot infections. Diabetes Obes Metab. 2019;21(6):1483–6.PubMedCrossRef
54.
go back to reference Haug F, Waibel FWA, Lisy M, Winkler E, Uçkay I, Schöni M. The impact of the length of total and intravenous systemic antibiotic therapy for the remission of diabetic foot infections. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2022;120:179–86. Haug F, Waibel FWA, Lisy M, Winkler E, Uçkay I, Schöni M. The impact of the length of total and intravenous systemic antibiotic therapy for the remission of diabetic foot infections. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2022;120:179–86.
55.
go back to reference Suzuki H, Mosher HJ, Heintz BH, Livorsi DJ. Implementation of a consensus protocol for antibiotic use for bone and joint infection to reduce unnecessary outpatient parenteral antimicrobial therapy: a quality improvement initiative. Antimicrob Steward Healthc Epidemiol ASHE. 2022;2(1):e6.PubMed Suzuki H, Mosher HJ, Heintz BH, Livorsi DJ. Implementation of a consensus protocol for antibiotic use for bone and joint infection to reduce unnecessary outpatient parenteral antimicrobial therapy: a quality improvement initiative. Antimicrob Steward Healthc Epidemiol ASHE. 2022;2(1):e6.PubMed
56.
go back to reference Mareau J, Alexander B, Egge J, Heintz B, Suzuki H, Livorsi DJ. Eligibility for and use of oral antimicrobial therapy among veterans with osteoarticular infections: a retrospective study across 8 medical centers. Open Forum Infect Dis. 2022;9(9):ofac450. Mareau J, Alexander B, Egge J, Heintz B, Suzuki H, Livorsi DJ. Eligibility for and use of oral antimicrobial therapy among veterans with osteoarticular infections: a retrospective study across 8 medical centers. Open Forum Infect Dis. 2022;9(9):ofac450.
57.
go back to reference Markham JL, Goldman JL. To discharge or not to discharge on outpatient parenteral antimicrobial therapy: that is the question. Hosp Pediatr. 2019;9(4):314–6.PubMedCrossRef Markham JL, Goldman JL. To discharge or not to discharge on outpatient parenteral antimicrobial therapy: that is the question. Hosp Pediatr. 2019;9(4):314–6.PubMedCrossRef
59.
go back to reference Li HK, Rombach I, Zambellas R, Walker AS, McNally MA, Atkins BL, et al. Oral versus intravenous antibiotics for bone and joint infection. N Engl J Med. 2019;380(5):425–36.PubMedPubMedCentralCrossRef Li HK, Rombach I, Zambellas R, Walker AS, McNally MA, Atkins BL, et al. Oral versus intravenous antibiotics for bone and joint infection. N Engl J Med. 2019;380(5):425–36.PubMedPubMedCentralCrossRef
60.
go back to reference Sendi P, Lora-Tamayo J, Cortes-Penfield NW, Uçkay I. Early switch from intravenous to oral antibiotic treatment in bone and joint infections. Clin Microbiol Infect. 2023;29(9):1133–8.PubMedCrossRef Sendi P, Lora-Tamayo J, Cortes-Penfield NW, Uçkay I. Early switch from intravenous to oral antibiotic treatment in bone and joint infections. Clin Microbiol Infect. 2023;29(9):1133–8.PubMedCrossRef
61.
go back to reference Bernard L, Dinh A, Ghout I, Simo D, Zeller V, Issartel B, et al. Antibiotic treatment for 6 weeks versus 12 weeks in patients with pyogenic vertebral osteomyelitis: an open-label, non-inferiority, randomised, controlled trial. Lancet Lond Engl. 2015;385(9971):875–82.CrossRef Bernard L, Dinh A, Ghout I, Simo D, Zeller V, Issartel B, et al. Antibiotic treatment for 6 weeks versus 12 weeks in patients with pyogenic vertebral osteomyelitis: an open-label, non-inferiority, randomised, controlled trial. Lancet Lond Engl. 2015;385(9971):875–82.CrossRef
62.
go back to reference Gjika E, Beaulieu JY, Vakalopoulos K, Gauthier M, Bouvet C, Gonzalez A, et al. Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial. Ann Rheum Dis. 2019;78(8):1114–21.PubMedCrossRef Gjika E, Beaulieu JY, Vakalopoulos K, Gauthier M, Bouvet C, Gonzalez A, et al. Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial. Ann Rheum Dis. 2019;78(8):1114–21.PubMedCrossRef
63.
go back to reference Gariani K, Pham TT, Kressmann B, Jornayvaz FR, Gastaldi G, Stafylakis D, et al. Three weeks versus six weeks of antibiotic therapy for diabetic foot osteomyelitis: a prospective, randomized, noninferiority pilot trial. Clin Infect Dis Off Publ Infect Dis Soc Am. 2021;73(7):e1539–45.CrossRef Gariani K, Pham TT, Kressmann B, Jornayvaz FR, Gastaldi G, Stafylakis D, et al. Three weeks versus six weeks of antibiotic therapy for diabetic foot osteomyelitis: a prospective, randomized, noninferiority pilot trial. Clin Infect Dis Off Publ Infect Dis Soc Am. 2021;73(7):e1539–45.CrossRef
64.
go back to reference Morgenstern C, Cabric S, Perka C, Trampuz A, Renz N. Synovial fluid multiplex PCR is superior to culture for detection of low-virulent pathogens causing periprosthetic joint infection. Diagn Microbiol Infect Dis. 2018;90(2):115–9.PubMedCrossRef Morgenstern C, Cabric S, Perka C, Trampuz A, Renz N. Synovial fluid multiplex PCR is superior to culture for detection of low-virulent pathogens causing periprosthetic joint infection. Diagn Microbiol Infect Dis. 2018;90(2):115–9.PubMedCrossRef
65.
go back to reference Balada-Llasat JM, Stamas N, Vincent T, Timbrook TT, Saiontz-Martinez C, Hemmert RB, et al. Epidemiology and economic outcomes associated with timely versus delayed receipt of appropriate antibiotic therapy among US patients hospitalized for native septic arthritis: a retrospective cohort study. Antibiotics. 2022;11(12):1732.PubMedPubMedCentralCrossRef Balada-Llasat JM, Stamas N, Vincent T, Timbrook TT, Saiontz-Martinez C, Hemmert RB, et al. Epidemiology and economic outcomes associated with timely versus delayed receipt of appropriate antibiotic therapy among US patients hospitalized for native septic arthritis: a retrospective cohort study. Antibiotics. 2022;11(12):1732.PubMedPubMedCentralCrossRef
66.
go back to reference Morata L, Cobo J, Fernández-Sampedro M, Guisado Vasco P, Ruano E, Lora-Tamayo J, et al. Safety and efficacy of prolonged use of dalbavancin in bone and joint infections. Antimicrob Agents Chemother. 2019;63(5):e02280–e2318.PubMedPubMedCentralCrossRef Morata L, Cobo J, Fernández-Sampedro M, Guisado Vasco P, Ruano E, Lora-Tamayo J, et al. Safety and efficacy of prolonged use of dalbavancin in bone and joint infections. Antimicrob Agents Chemother. 2019;63(5):e02280–e2318.PubMedPubMedCentralCrossRef
67.
go back to reference Bork JT, Heil EL, Berry S, Lopes E, Davé R, Gilliam BL, et al. Dalbavancin use in vulnerable patients receiving outpatient parenteral antibiotic therapy for invasive Gram-positive infections. Infect Dis Ther. 2019;8(2):171–84.PubMedPubMedCentralCrossRef Bork JT, Heil EL, Berry S, Lopes E, Davé R, Gilliam BL, et al. Dalbavancin use in vulnerable patients receiving outpatient parenteral antibiotic therapy for invasive Gram-positive infections. Infect Dis Ther. 2019;8(2):171–84.PubMedPubMedCentralCrossRef
68.
go back to reference Buzón Martín L, Mora Fernández M, Perales Ruiz JM, Ortega Lafont M, Álvarez Paredes L, Morán Rodríguez MA, et al. Dalbavancin for treating prosthetic joint infections caused by Gram-positive bacteria: a proposal for a low dose strategy. A retrospective cohort study. Rev Espanola Quimioter Publicacion Of Soc Espanola Quimioter. 2019;32(6):532–8. Buzón Martín L, Mora Fernández M, Perales Ruiz JM, Ortega Lafont M, Álvarez Paredes L, Morán Rodríguez MA, et al. Dalbavancin for treating prosthetic joint infections caused by Gram-positive bacteria: a proposal for a low dose strategy. A retrospective cohort study. Rev Espanola Quimioter Publicacion Of Soc Espanola Quimioter. 2019;32(6):532–8.
69.
go back to reference Dunne MW, Puttagunta S, Sprenger CR, Rubino C, Van Wart S, Baldassarre J. Extended-duration dosing and distribution of dalbavancin into bone and articular tissue. Antimicrob Agents Chemother. 2015;59(4):1849–55.PubMedPubMedCentralCrossRef Dunne MW, Puttagunta S, Sprenger CR, Rubino C, Van Wart S, Baldassarre J. Extended-duration dosing and distribution of dalbavancin into bone and articular tissue. Antimicrob Agents Chemother. 2015;59(4):1849–55.PubMedPubMedCentralCrossRef
70.
go back to reference Almangour TA, Alhifany AA. Dalbavancin for the management of osteomyelitis: a major step forward? J Antimicrob Chemother. 2020;75(10):2717–22.PubMedCrossRef Almangour TA, Alhifany AA. Dalbavancin for the management of osteomyelitis: a major step forward? J Antimicrob Chemother. 2020;75(10):2717–22.PubMedCrossRef
71.
go back to reference Brownell LE, Adamsick ML, McCreary EK, Vanderloo JP, Ernst EJ, Jackson ER, et al. Clinical outcomes and economic impact of oritavancin for Gram-positive infections: a single academic medical center health system experience. Drugs - Real World Outcomes. 2020;7(1):13–9.PubMedPubMedCentralCrossRef Brownell LE, Adamsick ML, McCreary EK, Vanderloo JP, Ernst EJ, Jackson ER, et al. Clinical outcomes and economic impact of oritavancin for Gram-positive infections: a single academic medical center health system experience. Drugs - Real World Outcomes. 2020;7(1):13–9.PubMedPubMedCentralCrossRef
72.
go back to reference Rappo U, Puttagunta S, Shevchenko V, Shevchenko A, Jandourek A, Gonzalez PL, et al. Dalbavancin for the treatment of osteomyelitis in adult patients: a randomized clinical trial of efficacy and safety. Open Forum Infect Dis. 2019;6(1):ofy331. Rappo U, Puttagunta S, Shevchenko V, Shevchenko A, Jandourek A, Gonzalez PL, et al. Dalbavancin for the treatment of osteomyelitis in adult patients: a randomized clinical trial of efficacy and safety. Open Forum Infect Dis. 2019;6(1):ofy331.
73.
go back to reference Bouza E, Valerio M, Soriano A, Morata L, Carus EG, Rodríguez-González C, et al. Dalbavancin in the treatment of different gram-positive infections: a real-life experience. Int J Antimicrob Agents. 2018;51(4):571–7.PubMedCrossRef Bouza E, Valerio M, Soriano A, Morata L, Carus EG, Rodríguez-González C, et al. Dalbavancin in the treatment of different gram-positive infections: a real-life experience. Int J Antimicrob Agents. 2018;51(4):571–7.PubMedCrossRef
74.
go back to reference Kakiuchi S, Perencevich EN, Livorsi DJ, Goto M. Is the number of prescriptions an appropriate metric for outpatient antimicrobial consumption? A comparison between the prescription counts and days supplied. Infect Control Hosp Epidemiol. 2023;44(6):941–4.PubMedCrossRef Kakiuchi S, Perencevich EN, Livorsi DJ, Goto M. Is the number of prescriptions an appropriate metric for outpatient antimicrobial consumption? A comparison between the prescription counts and days supplied. Infect Control Hosp Epidemiol. 2023;44(6):941–4.PubMedCrossRef
76.
go back to reference • Madaras-Kelly K, Hostler C, Townsend M, Potter EM, Spivak ES, Hall SK, et al. Impact of implementation of the core elements of outpatient antibiotic stewardship within Veterans Health Administration emergency departments and primary care clinics on antibiotic prescribing and patient outcomes. Clin Infect Dis Off Publ Infect Dis Soc Am. 2021;73(5):e1126–34. This quasi-experimental controlled study describes the impact that a multimodal approach focusing on the four CDC Core Elements of Outpatient Antibiotic Stewardship can have on reductions in inappropriate ARI prescribing. • Madaras-Kelly K, Hostler C, Townsend M, Potter EM, Spivak ES, Hall SK, et al. Impact of implementation of the core elements of outpatient antibiotic stewardship within Veterans Health Administration emergency departments and primary care clinics on antibiotic prescribing and patient outcomes. Clin Infect Dis Off Publ Infect Dis Soc Am. 2021;73(5):e1126–34. This quasi-experimental controlled study describes the impact that a multimodal approach focusing on the four CDC Core Elements of Outpatient Antibiotic Stewardship can have on reductions in inappropriate ARI prescribing.
77.
go back to reference Eudy JL, Pallotta AM, Neuner EA, Brummel GL, Postelnick MJ, Schulz LT, et al. Antimicrobial stewardship practice in the ambulatory setting from a national cohort. Open Forum Infect Dis. 2020;7(11):ofaa513. Eudy JL, Pallotta AM, Neuner EA, Brummel GL, Postelnick MJ, Schulz LT, et al. Antimicrobial stewardship practice in the ambulatory setting from a national cohort. Open Forum Infect Dis. 2020;7(11):ofaa513.
78.
go back to reference Jeffs L, McIsaac W, Zahradnik M, Senthinathan A, Dresser L, McIntyre M, et al. Barriers and facilitators to the uptake of an antimicrobial stewardship program in primary care: a qualitative study. PLoS ONE. 2020;15(3):e0223822.PubMedPubMedCentralCrossRef Jeffs L, McIsaac W, Zahradnik M, Senthinathan A, Dresser L, McIntyre M, et al. Barriers and facilitators to the uptake of an antimicrobial stewardship program in primary care: a qualitative study. PLoS ONE. 2020;15(3):e0223822.PubMedPubMedCentralCrossRef
79.
go back to reference Hartman EAR, Groen WG, Heltveit-Olsen SR, Lindbæk M, Høye S, Sundvall PD, et al. Decisions on antibiotic prescribing for suspected urinary tract infections in frail older adults: a qualitative study in four European countries. Age Ageing. 2022;51(6):afac134. Hartman EAR, Groen WG, Heltveit-Olsen SR, Lindbæk M, Høye S, Sundvall PD, et al. Decisions on antibiotic prescribing for suspected urinary tract infections in frail older adults: a qualitative study in four European countries. Age Ageing. 2022;51(6):afac134.
80.
go back to reference Zetts RM, Garcia AM, Doctor JN, Gerber JS, Linder JA, Hyun DY. Primary care physicians’ attitudes and perceptions towards antibiotic resistance and antibiotic stewardship: a national survey. Open Forum Infect Dis 2020;7(7):ofaa244. Zetts RM, Garcia AM, Doctor JN, Gerber JS, Linder JA, Hyun DY. Primary care physicians’ attitudes and perceptions towards antibiotic resistance and antibiotic stewardship: a national survey. Open Forum Infect Dis 2020;7(7):ofaa244.
Metadata
Title
Antibiotic Use at Hospital Discharge and Outpatient Antimicrobial Stewardship
Authors
Mandee Noval
Colleen Burgoyne
Jacinta Chin
Kathryn Dzintars
Aileen Jimenez
Angela Perhac
Jessa Brenon
Publication date
20-11-2023
Publisher
Springer US
Published in
Current Infectious Disease Reports / Issue 12/2023
Print ISSN: 1523-3847
Electronic ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-023-00824-6

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