Antimicrobial stewardship, procalcitonin testing, and rapid blood-culture identification to optimize sepsis care in critically ill adult patients: A quality improvement initiative

Wendy I Sligl; Justin Z Chen; Xiaoming Wang; Cheyanne Boehm; Karen Fong; Katelynn Crick; Míriam Garrido Clua; Cassidy Codan; Tanis C Dingle; Daniel Gregson; Connie Prosser; Hossein Sadrzadeh; Charles Yan; Guanmin Chen; Alena Tse-Chang; Daniel Garros; Christopher J Doig; David Zygun; Dawn Opgenorth; John M Conly; Sean M Bagshaw

doi:10.1017/ash.2023.183

Antimicrobial stewardship, procalcitonin testing, and rapid blood-culture identification to optimize sepsis care in critically ill adult patients: A quality improvement initiative

Antimicrob Steward Healthc Epidemiol. 2023 Jun 29;3(1):e107. doi: 10.1017/ash.2023.183. eCollection 2023.

Authors

Wendy I Sligl^{1

2}, Justin Z Chen², Xiaoming Wang³, Cheyanne Boehm⁴, Karen Fong⁵, Katelynn Crick¹, Míriam Garrido Clua¹, Cassidy Codan⁶, Tanis C Dingle⁷, Daniel Gregson^{8

9}, Connie Prosser¹⁰, Hossein Sadrzadeh¹¹, Charles Yan¹², Guanmin Chen¹³, Alena Tse-Chang¹⁴, Daniel Garros¹⁵, Christopher J Doig⁶, David Zygun¹, Dawn Opgenorth¹, John M Conly⁹, Sean M Bagshaw^{1

16}

Affiliations

¹ Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alberta, Canada.
² Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
³ Health Services Statistical and Analytic Methods, Alberta Health Services, Edmonton, Alberta, Canada.
⁴ Pharmacy Services, Foothills Medical Centre, Alberta Health Services, Calgary, Alberta, Canada.
⁵ Pharmacy Services, University of Alberta Hospital, Alberta Health Services, Edmonton, Alberta, Canada.
⁶ Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada.
⁷ Division of Diagnostic and Applied Microbiology, Department of Laboratory Medicine and Pathology, University of Alberta, and Alberta Precision Laboratories, Edmonton, Alberta, Canada.
⁸ Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada.
⁹ Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada.
¹⁰ Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.
¹¹ Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.
¹² Institute of Health Economics, Edmonton, Alberta, Canada.
¹³ Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
¹⁴ Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
¹⁵ Division of Pediatric Critical Care, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
¹⁶ Critical Care Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada.

Abstract

We examined the effect of an antimicrobial stewardship program (ASP), procalcitonin testing and rapid blood-culture identification on hospital mortality in a prospective quality improvement project in critically ill septic adults. Secondarily, we have reported antimicrobial guideline concordance, acceptance of ASP interventions, and antimicrobial and health-resource utilization.