Highlights
- •No studies have investigated the impact of real-time notification of culture results with rapid antimicrobial stewardship program (ASP) intervention in the setting of Clostridium difficile infection (CDI).
- •The implementation of a real-time notification system to alert a pharmacist-led ASP of CDI is a valuable strategy for decreasing time to effective antimicrobial therapy.
- •Real-time notification may lead to increased compliance and time to implementation of contact precautions.
Background
Clostridium difficile is a prominent nosocomial pathogen and is the most common causative organism of health
care–associated diarrhea. To our knowledge, no studies have investigated the impact
of real-time notification of culture results with rapid antimicrobial stewardship
program (ASP) intervention in the setting of C difficile infection (CDI). The purpose of this study was to assess the impact of real-time
notification of detection of toxigenic C difficile by DNA amplification results in patients with confirmed CDI.
Methods
This is a single-center, retrospective cohort study at a 433-bed tertiary medical
center in central Kentucky. The study consisted of 2 arms: patients treated for CDI
prior to implementation of real-time provider notification and patients postimplementation.
The primary outcome was time to initiation of effective antimicrobial therapy.
Results
The median time to initiation of effective antimicrobial therapy decreased from 5.75
hours in the preimplementation cohort to 2.05 hours in the postimplementation cohort
(P = .001). ASP intervention also resulted in a shorter time from detection of CDI to
order entry of effective antimicrobial therapy in the patient's electronic medical
record (3.0 vs 0.6 hours; P = .001).
Conclusions
The implementation of a real-time notification system to alert a pharmacist-led ASP
of toxigenic CDI resulted in statistically significant shorter times to order entry
and subsequent initiation of effective antimicrobial therapy and contact precautions.
Key Words
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Article info
Publication history
Published online: January 03, 2018
Footnotes
Conflicts of interest: Nothing to report.
Identification
Copyright
© 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
