PT  - JOURNAL ARTICLE
AU  - Jason Carr
AU  - Michael Lanspa
AU  - Brandon Webb
AU  - Nathan Dean
TI  - Long-term impact of DRIP score on antibiotic stewardship in patients with community acquired pneumonia
AID  - 10.1183/13993003.congress-2021.PA1739
DP  - 2021 Sep 05
TA  - European Respiratory Journal
PG  - PA1739
VI  - 58
IP  - suppl 65
4099  - http://erj.ersjournals.com/content/58/suppl_65/PA1739.short
4100  - http://erj.ersjournals.com/content/58/suppl_65/PA1739.full
SO  - Eur Respir J2021 Sep 05; 58
AB  - Introduction: Broad spectrum antibiotics are overused in the treatment of community acquired pneumonia (CAP). We have previously reported a validated risk score for drug-resistant pathogens (DRIP) whose implementation within electronic clinical decision support reduced empiric, inappropriate, broad-spectrum antibiotic use in CAP.Objectives: Evaluate whether DRIP implementation produced a durable reduction in the rate of broad-spectrum antibiotic prescription.Methods: We identified patients with CAP admitted to one of four hospitals in 3 cohorts: 1) pre-implementation (2011-2012), 2) shortly after DRIP implementation (2014-2015) and 3) long-term post-implementation (2017-2019). Antibiotics were classified as broad-spectrum if their spectrum included MRSA or P. Aeruginosa and were not appropriate based on CAP guidelines.Results: There were 3750 patients, 86% white, 51% women, median age 65. The cohorts had 1377, 1218 and 1155 patients, respectively. The rate of broad-spectrum antibiotic use in each cohort was 30.0%, 24.7% and 22.4%. Implementation of an electronic clinical decision support tool for empiric initial antibiotic selection in CAP resulted in a sustained decrease in extended-spectrum antibiotic use from prior to implementation through two periods afterward, p<0.001.Conclusions: Embedding a validated, automated risk score for predicting drug resistant pathogens in electronic clinical decision support resulted in a significant, durable reduction in broad-spectrum antibiotic use for CAP. This result highlights the critical role automated interventions can play in guiding important processes of care.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA1739.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).