MRSA
Conditions
Brief summary
To evaluate the impact of MRSA nasal screen implementation on duration of therapy and cost associated with vancomycin use.
Detailed description
Routine blood and sputum cultures are often obtained inpatient for critically ill pneumonia patients. These tests, however, tend to have a high yield of false positives, leading to an increase in the use of broad spectrum antibiotics, specifically vancomycin. The Methicillin-resistant Staphylococcus aureus(MRSA) nasal screen is an antimicrobial stewardship tool that can be used to guide the treatment of community-acquired, hospital-acquired and ventilator-associated pneumonia. Due to its strong negative predictive value; a negative result can accurately indicate the absence of an MRSA infection in 96% of cases. Long-term treatment with vancomycin in patients with pneumonia is nephrotoxic and not always warranted. The implementation of an MRSA nasal screen in all patients with pneumonia treated with vancomycin has the potential to reduce vancomycin duration of therapy, decrease the risk of adverse effects and decrease the cost associated with vancomycin use.
Interventions
OTHERDuration of therapy
The final data will then be compared to determine if the duration of therapy and cost after implementation of the MRSA nasal screen if significantly different from before the implementation of the MRSA nasal screen.
OTHERDirect Cost
Direct costs of vancomycin for each treatment arm (in US dollars).
OTHERPharmacokinectic Monitoring
Number of vancomycin levels drawn for pharmacokinetic monitoring.
OTHERHospital stay
Length of hospital stay in days
Sponsors
Methodist Health System
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age \> 18 years 2. Diagnosis of pneumonia 3. Admission inpatient to Methodist Richardson Medical Center 4. Treatment with vancomycin empirically
Exclusion criteria
1. Age ≤ 18 years 2. Patients with other confirmed gram positive infections
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Duration of therapy | 1 year | To analyze duration of vancomycin in days. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORDaniel Betina
Methodist Health System
Outcome results
None listed