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Letourneau, Alyssa

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Letourneau

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Alyssa

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Letourneau, Alyssa

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2014 - 20172

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Author's Publications: search.filters.isAuthorOfPublication.66cda0f1-aac9-4ae8-93dd-8cacbe8584aa

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    Working Together to Define Antibiotic Appropriateness: Point Prevalence Survey in 47 Intensive Care Units from 12 US Hospitals, Partnership for Quality Care, March 2017
    (Oxford University Press, 2017) Trivedi, Kavita K; Ostrowsky, Belinda; Abbo, Lilian M; Srinivasan, Arjun; Bartash, Rachel; Cassera, Fred; Fleisher, Jorge; Kubiak, David W; Letourneau, Alyssa; Nori, Priya; Parodi, Stephen; Aragon, Laura; Dollard, Eliza; Gagliardo, Christina; Ghitan, Monica; Giles, Amber; Mayer, Suri; Quevedo, Jennifer; Rieg, Gunter; Shteyman, Galina; Vargas, Jaclyn; Kelley, Shannon; Silver, Phyllis
    Abstract Background: A national assessment of antibiotic appropriateness in intensive care units (ICUs) with benchmarking was performed to assist antibiotic stewardship programs (ASPs) identify improvement opportunities. Methods: A Centers for Disease Control and Prevention tool was adapted by an expert panel from the Partnership for Quality Care (PQC), a coalition dedicated to high quality care in US hospitals, to validate appropriate antibiotic use measurement via a point prevalence survey on a single day. Data were collected by ASP personnel at each hospital, de-identified and submitted in aggregate to PQC for benchmarking. Hospitals identified reasons for inappropriate antibiotic use by category and antibiotics misused. Results: Forty-seven ICUs from 12 PQC hospitals participated: California (2), Florida (2), Massachusetts (3), Minnesota (1), and New York (4). Most hospitals identified as teaching (83%) with 252-1550 bed size (median: 563) and 20–270 licensed ICU beds (median: 70). All hospitals reported a formal ASP. On March 1, 2017, 362 (54%) of 667 patients in participating ICUs were on antibiotics (range: 8-81 patients); 1 patient was not assessed. Of the remaining 361 antibiotic regimens, 112 (31%) were identified as inappropriate from among all 12 hospitals (range: 9-82%) (figure). The table displays inappropriate antibiotic use by ICU type. Reasons for inappropriate use included unnecessarily broad spectrum of activity (29%), duration longer than necessary (21%), and treatment of a non-infectious syndrome (19%). The antibiotic most commonly misused was vancomycin in 7 (58%) hospitals. Conclusion: Up to 80% of antibiotic use in some ICUs is inappropriate, underscoring the need for ASP interventions, standardized assessment tools and benchmarking. Strategies should focus on de-escalation of broad-spectrum antibiotics and reducing duration of therapy. Disclosures D. W. Kubiak, Shionogi: Consultant, Consulting fee. Astellas Pharma: Consultant, Consulting fee
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    942How Do Hospitals Detect Outbreaks?
    (Oxford University Press, 2014) Baker, Meghan; Huang, Susan S.; Letourneau, Alyssa; Kaganov, Rebecca E.; Peeples, Jennifer R.; Drees, Marci; Yokoe, Deborah S.