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CIDRAP Stewardship/Resistance Scan - Ambulatory care stewardship; Point-of-care testing

Shiloh

Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2019/06/stewardship-resistance-scan-jun-21-2019


Stewardship / Resistance Scan for Jun 21, 2019
Ambulatory care stewardship; Point-of-care testing

Filed Under:
Antimicrobial Stewardship; Diagnostics

[h=3]Joint Commission announces stewardship measures for ambulatory care[/h] The Illinois-based Joint Commission, which accredits healthcare facilities for receipt of Medicaid and Medicare reimbursements, has created five new performance measures for antimicrobial stewardship requirements in ambulatory care centers, the commission announced yesterday.
The requirements will become effective on Jan 1, 2020. The new elements of performance align with current recommendations from scientific and professional organizations, the Joint Commission said in a news release, and address the following concepts:
  • Identifying an antimicrobial stewardship leader
  • Establishing an annual antimicrobial stewardship goal
  • Implementing evidence-based practice guidelines related to the stewardship goal
  • Providing clinical staff with educational resources related to the goal
  • Collecting, analyzing, and reporting related data
The commission developed the new standards after literature and public field reviews and input from two expert panels.
"With improving patient safety as its goal, The Joint Commission developed new requirements to help decrease misuse of antimicrobial medications, which contributes to antibiotic resistance and adverse drug events," the commission said. "This project is a continuation of The Joint Commission?s ongoing initiative to promote the appropriate use of antimicrobial medications in the hospital, critical access hospital and nursing care center programs."
Jun 20 Joint Commission news release

[h=3]Special point-of-care test tied to fewer antibiotics with respiratory infection[/h] A single-center randomized clinical trial in Beijing has found that a molecular point-of-care test (POCT) for viral and atypical pathogens added to routine real-time polymerase chain reaction (rt-PCR) testing might help reduce intravenous (IV) antibiotics in hospitalized patients who have lower respiratory tract infections, according to findings yesterday in Clinical Microbiology and Infection.
The study compared the POCT FilmArray Panel, which tests for 20 viral and atypical pathogens, plus rt-PCR with a control group that received only routine rt-PCR for 10 pathogens. The researchers enrolled 398 patients in the intervention group and 402 in the control group.
The found that duration of IV antibiotics in the intervention group was shorter than in the control (7.0 vs 8.0 days). In addition, length of hospital stay was 8.0 days compared with 9.0 days, and the cost of hospitalization in the intervention group was $1,805, compared with $2,043. Also, de-escalation was achieved within 72 hours in 7.9% of patients in the intervention group and 3.2% in the control group, with de-escalation in 29.7% and 22.0%, respectively, within 3 to 7 days.
Jun 20 Clin Microbiol Infect abstract
 
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