Evaluation of an Animal Bite Protocol in the Emergency Department Spelts R, McAllister M, Tabb D, Baxley J, Woldu H, Bauer M, Lad P Columbus Regional Health - Columbus, GA
Background/Purpose: Transmission of rabies virus occurs when an uninfected animal or human comes into contact with the saliva of a rabid animal through bites or scratches which ultimately leads to death. Human rabies can be prevented after possible exposure through post-exposure prophylaxis (PEP) which consists of active and passive immunization over a 14 day period. Although the case fatality rate is nearly 100%, the incidence of human rabies is low, with one to three cases per year in the United States (US). Despite the small number of infections, the US spends an estimated $245-$510 million each year on rabies diagnostics, prevention, and control. The Centers for Disease Control and Prevention (CDC) provides recommendations regarding which patients should receive rabies PEP, though several studies demonstrate a high frequency of inappropriate prescribing of rabies PEP. The purpose of this study is to determine if implementation of an animal bite protocol improves compliance with the CDC recommendations regarding treatment of patients presenting to the emergency department (ED) with an animal bite. Potential cost-savings will also be evaluated.
Methodology: An institutional review board approved, single-center, retrospective chart review was conducted from January 1, 2017 to March 16, 2018 to evaluate patients presenting to the ED with an animal bite before and after implementation of an animal bite protocol. All patients presenting to the ED with an animal bite occurring in Georgia were included. The primary outcome, appropriateness of rabies PEP, was evaluated based on CDC recommendations. Cost-savings secondary to decreased inappropriate use of rabies PEP after the implementation of the protocol was a secondary endpoint.
Presentation Objective: Explain the potential benefits of implementing a hospital-approved animal bite protocol in an emergency department.
Self-Assessment: How can pharmacists improve patient care through a hospital-approved animal bite protocol?
