2010. A Significant Reduction in Empiric Vancomycin Days of Therapy for Suspected MRSA Pneumonia in Adult Non-ICU Patients After Implementation of a Rapid MRSA Nasal PCR Test with Antimicrobial Stewardship Intervention

摘要

BackgroundMethicillin-resistant Staphylococcus aureus (MRSA), when implicated in respiratory tract infections, can be associated with significant morbidity and mortality. The prevalence of severe MRSA pneumonia may be as high as 10%; however, recent evidence suggests that MRSA is much less prevalent as a cause of community-acquired pneumonia (CAP) among community-dwelling patients and may be as low as 0.1%. Nonspecific features of pneumonia in non-ICU patients (viral co-infection, multi-lobar infiltrates) often lead clinicians to cautiously initiate empiric anti-MRSA therapy. Recommendations of when to safely de-escalate empiric treatment prior to known respiratory cultures are not established. To decrease anti-MRSA therapy in non-ICU pneumonia patients with a low probability of MRSA pneumonia, we employed a nasal screening paired with antimicrobial stewardship intervention.