P-1739. Impact of a Urinary Tract Infection Treatment Algorithm on Antimicrobial Prescribing at a Small Rural Hospital without Formally Trained Infectious Disease Team Members
Abstract
Abstract Background Small, rural community hospitals lack certified infectious disease (ID) staff, which can make antimicrobial stewardship (AMS) interventions challenging. At our Critical Access Hospital, we developed a treatment algorithm for urinary tract infections (UTIs) and assessed appropriate duration of therapy (DOT), and appropriate antimicrobial selection in cases before and after implementation of our algorithm. Figure 1. Methods In this retrospective observational study, the AMS team published a treatment algorithm for UTIs (Figure 1) in Q1 2023. Implementation of the algorithm focused on physician exposure, buy-in, and follow-up. A webpage was created to house the algorithm. Buy-in was obtained from key physicians. Antimicrobial prescribing was reviewed at quarterly AMS meetings and physician leaders took this information back to their teams for review. A retrospective review was performed after 2 quarters of interventions. We obtained prescribing data via electronic health records. Baseline characteristics are in Table 1. Each UTI case was manually reviewed for DOT and appropriateness of antibiotic choice as defined by agreement with our algorithm. Results The study included in-patients who were treated for UTI between 10/1/21 through 3/31/22, and 10/1/23 through 3/31/24. Exclusion criteria included concomitant infections, inability to follow-up, and expiration. A t-test was performed to compare antibiotic DOT for UTI treatment. The distribution of DOT is…
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