Impact of Penicillin Allergy on Empirical Carbapenem Use in Gram-Negative Bloodstream Infections: An Antimicrobial Stewardship Opportunity

摘要: Objectives Retrospective matched cohort study evaluating association between penicillin allergy and empirical carbapenem use in gram-negative bloodstream infections (BSI) utility of antimicrobial stewardship interventions reducing utilization. Methods Hospitalized adults with community-onset BSI from January 1, 2010 to June 30, 2015 at two large community hospitals Columbia, SC were identified. Antimicrobial targeting utilization fully implemented 2014. Multivariate logistic regression was used examine impact on use. Kaplan-Meier analysis evaluate time de-escalation patients before after interventions. Results Patients (n=140) more likely receive therapy for compared those without (27% vs. 12%, p=0.002). After adjustments the multivariate model, (odds ratio [OR] 3.98, 95% confidence intervals [CI]: 1.98-8.45) prior β-lactam (OR 2.72, CI: 1.07-6.64) independently associated use, whereas decline 0.41, 0.16-0.94). Among who prescribed carbapenems, median significantly shorter post- versus pre-intervention period (2.0 4.2 days, p=0.004). Conclusion Penicillin a significant contributor BSI. This subject modification by which successfully reduced overall duration allergy. This article is protected copyright. All rights reserved.