2025 Southeastern Residency Conference

Title: Impact of an Antibiotic Guide Paired with Audit and Feedback on Antipseudomonal Antibiotic Use in a Community Hospital


Authors: Olivia Bray, Linda Johnson


Objective: The purpose of this retrospective review is to evaluate the impact of the antimicrobial stewardship intervention in reducing the inappropriate use of piperacillin/tazobactam and cefepime when possible. 


Self Assessment Question: True / False - It is appropriate to use antipseudomonal antibiotic coverage in all patients with community-aquired gram-negative infections. 


Background: Overuse of broad spectrum antibiotics such as piperacillin/tazobactam and cefepime can lead to increased resistance and difficult to treat organisms. Our institution uses more piperacillin/tazobactam and cefepime than expected, with the majority of inappropriate use during the empiric phase of treatment. Based on this data, guidelines for appropriate use of piperacillin/tazobactam and cefepime were developed and distributed to providers. Furthermore, the antimicrobial stewardship pharmacist performed focused reviews and direct provider interventions Monday thru Friday to reduce inappropriate use. 


Methods: Adult patients admitted to the hosptial initiated on antibiotics for gram negative rod infections for at least 48 hours during November 2023 (pre-period) and November 2024 (post-period) were included. Patients were excluded if not being managed by the hospitalist service or admitted to intensive care units, adult step down units, or hematology/oncology units. Patients being managed by the infectious disease services were also excluded.


Results: In progress


Conclusion: In progress