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Antibiotic Stewardship

Antibiotic Stewardship

ASSURE: Antibiotic Stewardship for Ambulatory Surgery Prophylaxis

N/A- study begins Year 4

CACTIS: The Communication And Coaching To Increase Steward Influence

PI: Julia E. Szymczak, PhD

Funding Source: CDC Prevention Epicenter Program 

Title: The Communication And Coaching To Increase Steward Influence (CACTIS) Intervention to Maximize the Effectiveness of Post Prescription Review with Feedback: A Pilot Feasibility Study
 

Area of Focus:  

It is well-established that antimicrobial stewardship programs (ASPs) can reduce unnecessary antimicrobial use, decrease adverse drug events, and improve patient outcomes, such as reducing Clostridioides difficile infections. However, a critical research gap exists in the identification of strategies to implement and sustain evidence-based ASP interventions such that their full benefits across settings are realized. Studies have demonstrated the importance of face to face communication in ASP, but none have evaluated ways to increase the effectiveness of the way ASP personnel communicate on prescriber acceptance of interventions to optimize antimicrobial use. 

Specific Aims: 

The goal of this study is to evaluate the feasibility, acceptability, and preliminary impact of an ASP personnel-directed communication and coaching intervention to increase prescriber acceptance of post-prescription review with feedback (PPRF) recommendations. The project has three aims:(1)To optimize the Communication and Coaching to Increase Steward Influence (CACTIS) intervention via a collaborative expert stakeholder panel drawn from the CDC Epicenters Working Group (2) To determine the feasibility and acceptability of the CACTIS intervention to ASP personnel(3) To explore the impact of the CACTIS intervention on rates of prescriber acceptance of PPRF recommendations to discontinue, deescalate or change the duration of an antimicrobial prescription. Our long-term goal is to use the findings of this study to inform a large multisite stepped-wedge cluster-randomized trial to test hypotheses about the effects of the CACTIS intervention on acceptance of PPRF, antimicrobial appropriateness, and patient outcomes. 

EMPOWER - Using Electronically Derived AutoMated RePOrts of Appropriate Antibiotic use to Inform SteWardship IntERventions

PI: Ebbing Lautenbach

 

Adult Project Lead: Lauren Dutcher

 

Pediatric Project Lead: Kathleen Chiotos 

 

Study dates: 9/1/21 –8/31/23

 

Funding source: CDC contract

 

Area of focus:

Use of electronically derived automatic reports of appropriate antibiotic use in stewardship interventions for pharyngitis and community acquired pneumonia

 

Specific Aims:

1.Use automated reports to assess appropriateness of antibiotic use for: 1) adult inpatients with community acquired pneumonia (CAP); 2) pediatric inpatients with CAP; 3) adult outpatients with acute pharyngitis; and 4) pediatric outpatients with acute pharyngitis

2.Design and implement a scalable and sustainable antibiotic stewardship feedback reported-based intervention for these four conditions

3.Track the impact of stewardship interventions and report to key stakeholders, including prescribers

4.Create a publicly available toolkit based on the findings of this project that includes: (1) analytic tools and resources for using the automated reports of key indicators to target stewardship interventions and (2) an implementation guide to inform the application of automated reports to stewardship in the inpatient and outpatient settings

NAPS: Natural Language Processing for Antibiotic Prescribing in Sinusitis

PI: Lauren Dutcher and Keith Hamilton

 

Study dates: 6/1/21 –5/31/23

 

Funding source: CDC Prevention Epicenters Program

 

Area of focus:
Natural language processing for antibiotic prescribing in sinusitis

 

Specific Aim 1:

Sub-Aim A: To develop a natural language processing (NLP)algorithm to determine appropriateness of antibiotic therapy for adultpatients with acute sinusitis.

Sub-Aim B: To validate and evaluate performance characteristics of the adult sinusitis NLP algorithm. Hypothesis:An NLP algorithm to determine appropriateness of antibiotic therapy for sinusitis in adults will be associated with high accuracy.

 

Specific Aim 2:

Sub-Aim A: To develop an NLP algorithm to determine appropriateness of antibiotic therapy for pediatricpatients with acute sinusitis.

Sub-Aim B: To validate and evaluate performance for the pediatric sinusitis NLP algorithm.Hypothesis:An NLP algorithm to determine appropriateness of antibiotic therapy for sinusitis in pediatric patients will be associated with high accuracy.

RAPID: Reducing Antimicrobial Prescribing in Dialysis

Starting in Q3

MOSAIC: Investigating Antimicrobial Stewardship Practices in Southern Africa (MOSAIC)

PI: Ebbing Lautenbach, MD, MPH, MSCE

 

Study dates: 08/01/21 –07/31/23

 

Funding source: CDC

 

Title: Investigating Antimicrobial Stewardship Practices in Southern Africa (MOSAIC)

 

Area of focus: antibiotic stewardship; global health

 

Specific Aims:

The goals of this project are 1) To develop survey instruments that measure national-level and hospital-level AS practices, resources, and needs for use in a global context, 2) To conduct a comprehensive survey of AS practices, resources and needs at the national-level and hospital-level across three countries in Southern Africa, 3) To identify national-level and hospital-level contextual barriers and facilitators to the implementation of AS in Botswana and 4) To examine the impact of a stakeholder-engaged capacity building process on knowledge and attitudes towards AS in Botswana.

Using Electronically Derived Automated Reports of Appropriate Antibiotic Use to Inform Stewardship Interventions

PI: Ebbing Lautenbach, MD, MSCE, MPH

Study Dates: 09/01/21 – 08/31/23

Funding Source: CDC

Area of Focus:
Antibiotic Stewardship

Specific Aims: 
This project will assess the impact on antibiotic use of previously developed automated reports to identify inappropriate antibiotic prescribing in targeted inpatient and outpatient conditions in adults and children.