Effect of Academic Detailing with Prescribers as an Antimicrobial Stewardship Intervention in Solid Organ Transplant Patients.
1University Health Network, Toronto, ON, Canada
2Sinai Health System, Toronto, ON, Canada
Meeting: 2017 American Transplant Congress
Abstract number: 344
Keywords: Infection, Kidney transplantation, Liver transplantation, Lung transplantation
Session Information
Session Name: Concurrent Session: Infectious Pot-Pourri
Session Type: Concurrent Session
Date: Monday, May 1, 2017
Session Time: 4:30pm-6:00pm
Presentation Time: 5:42pm-5:54pm
Location: E265
Introduction
The role of academic detailing (AD) as an antimicrobial stewardship intervention, where the steward meets the prescribers in their practice setting to provide personal educational intervention, with evidence-based information for clinical decision making at the patient level, is not well defined in solid organ transplant (SOT) patients. We aim to assess AD's effect on antimicrobial prescriptions in concordance with principles of antimicrobial stewardship according to the US Centers for Disease Control and Prevention.
Method
We implemented twice-weekly AD with prescribers in our SOT program in Nov 2015. Post-implementation, we conducted two real-time audits of antimicrobial regimens on Aug 12 and Oct 3 2016. We assessed each prescription based on timeliness of initiation, spectrum of activity, dose, route, de-escalation/tailoring, and duration. We reviewed microbiology results, source control attainment, clinical history, patient factors and literature for guidance. Outcomes were compared with baseline audits from 2013 by [chi]2 test .
Results
Analyses were performed on 176 audits pre-implementation, and 133 post-implementation. The 3 most common transplantations were lung, liver and kidney. Pre-implementation, median age of patients was 58.4 years, with 58.5% male; post-implementation, median age was 57.8, with 62.4% male.
| Outcomes | Pre-implementation | Post-implementation | P-value |
| Audits with ≥1 antimicrobial treatment | 103/176 (58.5) | 79/133 (59.3) | 0.88 |
| Number (%) of stewardship-concordant audits | 72/103 (69.9) | 67/79 (84.8) | 0.02 |
| Number (%) of audits with ID consult | 56/103 (54.4) | 40/79 (50.6) | 0.25 |
| Number (%) of stewardship-concordant audits under ID consult | 44/56 (78.5) | 33/40 (82.5) | 0.63 |
Conclusion
AD significantly increased the percentage of antimicrobials prescribed in concordance with antimicrobial stewardship principles in solid organ transplant patients.
CITATION INFORMATION: So M, Morris A, Bell C, Humar A, Husain S. Effect of Academic Detailing with Prescribers as an Antimicrobial Stewardship Intervention in Solid Organ Transplant Patients. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
So M, Morris A, Bell C, Humar A, Husain S. Effect of Academic Detailing with Prescribers as an Antimicrobial Stewardship Intervention in Solid Organ Transplant Patients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/effect-of-academic-detailing-with-prescribers-as-an-antimicrobial-stewardship-intervention-in-solid-organ-transplant-patients/. Accessed May 17, 2025.« Back to 2017 American Transplant Congress