Limited impact of a nudge comment in promoting de-escalation to first-generation cephalosporins in urinary tract infections

Martin T Brenneman; Sarah E Moore; Matthew Song; Brian C Bohn; Elena A Swingler; Christopher W Whitman; Alan D Junkins; Ashley M Wilde

doi:10.1017/ash.2022.297

Limited impact of a nudge comment in promoting de-escalation to first-generation cephalosporins in urinary tract infections

Antimicrob Steward Healthc Epidemiol. 2022 Sep 26;2(1):e160. doi: 10.1017/ash.2022.297. eCollection 2022.

Authors

Martin T Brenneman¹, Sarah E Moore², Matthew Song², Brian C Bohn³, Elena A Swingler², Christopher W Whitman⁴, Alan D Junkins⁵, Ashley M Wilde²

Affiliations

¹ Pharmacy Department, Norton Healthcare, Louisville, Kentucky.
² Norton Infectious Diseases Institute, Norton Healthcare, Louisville, Kentucky.
³ Department of Pharmacy, Barnes-Jewish Hospital, Saint Louis, Missouri.
⁴ Pharmacy Department, Mobile Infirmary Medical Center, Mobile, Alabama.
⁵ Microbiology Department, Norton Healthcare, Louisville, Kentucky.

Abstract

In this study, we evaluated the impact of a microbiology nudge on de-escalation to first-generation cephalosporins in hospitalized patients with urinary tract infections secondary to Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis isolates with minimum inhibitory concentrations (MICs) ≤ 16 µg/mL. De-escalation to first generation-cephalosporins was uncommon at MICs = 4-16 µg/mL.