UTILIZING ANTIMICROBIAL STEWARDSHIP TO OPTIMIZE TREATMENT OF CHLAMYDIA AND GONORRHEA AT THE EMERGENCY DEPARTMENT Sajia Kotwal, Elizabeth Barrett, Dora Niculas, Joshua Shoemaker Dekalb Medical Center - Decatur, GA
Background/Purpose: Neisseria gonorrheae (GC) and Chlamydia trachomatis (CT) are two of the most common bacterial sexually transmitted infections in the United States. Despite their increased prevalence, their diagnoses continue to be a challenge in most emergency departments (ED). The turnaround time for GC/CT test results is 1-4 days in most hospitals, leading providers to empirically treat patients for GC/CT in the ED. The institution at which this study was conducted, an urban community hospital, found that 75% of patients empirically treated for GC/CT tested negative over the past year. Excess antimicrobial use in test-negative patients contributes to increased antimicrobial resistance and healthcare costs. ED pharmacists play a significant role in enhancing the appropriate use of antimicrobials and optimizing antimicrobial stewardship in the ED. The purpose of this project is to optimize antimicrobial utilization in the ED by implementing processes to reduce unnecessary testing and treatment of GC/CT._x000D_ _x000D_ _x000D_
Methodology: This project is a multifaceted, pre-post study that compares a prospective cohort to a historical control in order to evaluate treatment appropriateness of GC/CT before and after pharmacist-driven changes were implemented. Interventions included elimination of GC/CT tests from several common ED order sets, elimination of a nurse-driven STD protocol, and the implementation of a new STD order set available to ED providers only. Eligible patients were adults tested for GC/CT in the ED. The primary endpoint was the percentage of patients who received appropriate treatment for GC/CT during their index ED visit after implementation of interventions. Secondary endpoints included time to test results, time to treatment, ED length of stay, and cost of care. _x000D_ _x000D_ _x000D_ _x000D_
Presentation Objective: Assess the benefits of implementing an STD order set and optimizing the antimicrobial stewardship program_x000D_
Self-Assessment: What are the challenges of changing the way we currently treat GC/CT in the ED?
