Impact of an emergency medicine pharmacist on initial antibiotic prophylaxis for open fractures in trauma patients
Targeted antibiotic treatment reduces the infection risk of open fractures when soft tissue and bone are exposed to the environment. The risk of infection increases with higher degrees of injury. The Gustilo-Anderson system was developed to identify the degree of injury of open fractures and can be...
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| Veröffentlicht in: | The American journal of emergency medicine 2018-02, Vol.36 (2), p.290-293 |
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| creator | Harvey, Somer Brad Hall, A. Wilson, Kayla |
| description | Targeted antibiotic treatment reduces the infection risk of open fractures when soft tissue and bone are exposed to the environment. The risk of infection increases with higher degrees of injury. The Gustilo-Anderson system was developed to identify the degree of injury of open fractures and can be utilized to guide initial antibiotic therapy. Few studies have been published evaluating the potential impact of emergency medicine pharmacists in trauma, and currently no study has evaluated a pharmacist's influence on antibiotic selection and timing for open fractures.
The objective of this study was to determine the impact of an emergency medicine pharmacist on initial antibiotic selection and timing in trauma patients with open fractures.
This was a retrospective cohort study. Trauma alerts with open fractures from May 1, 2014 to June 30, 2016 were eligible for inclusion. The primary outcome was to determine if pharmacist participation during trauma resuscitation was associated with an increased proportion of initial antibiotic selection meeting guideline recommendations. The secondary outcome was the door-to-antibiotic administration time during resuscitation.
Initial prophylactic antibiotic recommendations were met in 81% of trauma resuscitations when a pharmacist was present versus 47% without a pharmacist present (p |
| doi_str_mv | 10.1016/j.ajem.2017.10.039 |
| format | Article |
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The objective of this study was to determine the impact of an emergency medicine pharmacist on initial antibiotic selection and timing in trauma patients with open fractures.
This was a retrospective cohort study. Trauma alerts with open fractures from May 1, 2014 to June 30, 2016 were eligible for inclusion. The primary outcome was to determine if pharmacist participation during trauma resuscitation was associated with an increased proportion of initial antibiotic selection meeting guideline recommendations. The secondary outcome was the door-to-antibiotic administration time during resuscitation.
Initial prophylactic antibiotic recommendations were met in 81% of trauma resuscitations when a pharmacist was present versus 47% without a pharmacist present (p<0.01). The median door-to-antibiotic time was 14min in the PHARM group versus 20min in the NO-PHARM group (p=0.02).
The participation of an EM pharmacist during initial trauma resuscitation resulted in improved initial antibiotic selection and faster door-to-antibiotic administration times in trauma patients with open fractures.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2017.10.039</identifier><identifier>PMID: 29079370</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Anti-Bacterial Agents - administration & dosage ; Antibiotic Prophylaxis - methods ; Antibiotics ; Classification ; Drug dosages ; Drug stores ; Emergency medical care ; Emergency medical services ; Female ; Florida - epidemiology ; Follow-Up Studies ; Fractures ; Fractures, Open - complications ; Health risks ; Humans ; Incidence ; Infections ; Male ; Middle Aged ; Open fracture ; Pharmacist ; Pharmacists ; Physicians ; Prophylaxis ; Retrospective Studies ; Trauma ; Trauma Centers ; Wound Infection - epidemiology ; Wound Infection - etiology ; Wound Infection - prevention & control</subject><ispartof>The American journal of emergency medicine, 2018-02, Vol.36 (2), p.290-293</ispartof><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-96817afa6754d0727dfe45386edcab6a0bf3c3956fcf2553855971f12e0a7cef3</citedby><cites>FETCH-LOGICAL-c384t-96817afa6754d0727dfe45386edcab6a0bf3c3956fcf2553855971f12e0a7cef3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2007532109?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29079370$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Harvey, Somer</creatorcontrib><creatorcontrib>Brad Hall, A.</creatorcontrib><creatorcontrib>Wilson, Kayla</creatorcontrib><title>Impact of an emergency medicine pharmacist on initial antibiotic prophylaxis for open fractures in trauma patients</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>Targeted antibiotic treatment reduces the infection risk of open fractures when soft tissue and bone are exposed to the environment. The risk of infection increases with higher degrees of injury. The Gustilo-Anderson system was developed to identify the degree of injury of open fractures and can be utilized to guide initial antibiotic therapy. Few studies have been published evaluating the potential impact of emergency medicine pharmacists in trauma, and currently no study has evaluated a pharmacist's influence on antibiotic selection and timing for open fractures.
The objective of this study was to determine the impact of an emergency medicine pharmacist on initial antibiotic selection and timing in trauma patients with open fractures.
This was a retrospective cohort study. Trauma alerts with open fractures from May 1, 2014 to June 30, 2016 were eligible for inclusion. The primary outcome was to determine if pharmacist participation during trauma resuscitation was associated with an increased proportion of initial antibiotic selection meeting guideline recommendations. The secondary outcome was the door-to-antibiotic administration time during resuscitation.
Initial prophylactic antibiotic recommendations were met in 81% of trauma resuscitations when a pharmacist was present versus 47% without a pharmacist present (p<0.01). The median door-to-antibiotic time was 14min in the PHARM group versus 20min in the NO-PHARM group (p=0.02).
The participation of an EM pharmacist during initial trauma resuscitation resulted in improved initial antibiotic selection and faster door-to-antibiotic administration times in trauma patients with open fractures.</description><subject>Adult</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Antibiotic Prophylaxis - methods</subject><subject>Antibiotics</subject><subject>Classification</subject><subject>Drug dosages</subject><subject>Drug stores</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Female</subject><subject>Florida - epidemiology</subject><subject>Follow-Up Studies</subject><subject>Fractures</subject><subject>Fractures, Open - complications</subject><subject>Health risks</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infections</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Open fracture</subject><subject>Pharmacist</subject><subject>Pharmacists</subject><subject>Physicians</subject><subject>Prophylaxis</subject><subject>Retrospective Studies</subject><subject>Trauma</subject><subject>Trauma Centers</subject><subject>Wound Infection - epidemiology</subject><subject>Wound Infection - etiology</subject><subject>Wound Infection - prevention & control</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kUuLFDEUhYMoTjv6B1xIwI2bavOoVDrgRgYfAwNudB3SqRsnRVVSJimx_7236dGFC1eBm-8c7j2HkJec7Tnjw9tp7yZY9oJxjYM9k-YR2XElRXfgmj8mO6al6gat9BV5VuvEGOe96p-SK2GYNlKzHSm3y-p8ozlQlygsUL5D8ie6wBh9TEDXe1cW52NFJtGYYotuRrbFY8wterqWvN6fZvcrVhpyoXmFRENB061ARQVtxW2Lo6trEVKrz8mT4OYKLx7ea_Lt44evN5-7uy-fbm_e33VeHvrWmQGvcMHh_v3ItNBjgF7JwwCjd8fBsWOQXho1BB-Ewg-ljOaBC2BOewjymry5-OKGPzaozS6xephnlyBv1XKjdG-EFhLR1_-gU95Kwu2sYExjpJwZpMSF8iXXWiDYtcTFlZPlzJ4bsZM9N2LPjZxn2AiKXj1Yb0cM9a_kTwUIvLsAgFn8jFBs9ZiTxwIK-GbHHP_n_xujfZ3_</recordid><startdate>201802</startdate><enddate>201802</enddate><creator>Harvey, Somer</creator><creator>Brad Hall, A.</creator><creator>Wilson, Kayla</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201802</creationdate><title>Impact of an emergency medicine pharmacist on initial antibiotic prophylaxis for open fractures in trauma patients</title><author>Harvey, Somer ; Brad Hall, A. ; Wilson, Kayla</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-96817afa6754d0727dfe45386edcab6a0bf3c3956fcf2553855971f12e0a7cef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Antibiotic Prophylaxis - methods</topic><topic>Antibiotics</topic><topic>Classification</topic><topic>Drug dosages</topic><topic>Drug stores</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Female</topic><topic>Florida - epidemiology</topic><topic>Follow-Up Studies</topic><topic>Fractures</topic><topic>Fractures, Open - complications</topic><topic>Health risks</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infections</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Open fracture</topic><topic>Pharmacist</topic><topic>Pharmacists</topic><topic>Physicians</topic><topic>Prophylaxis</topic><topic>Retrospective Studies</topic><topic>Trauma</topic><topic>Trauma Centers</topic><topic>Wound Infection - epidemiology</topic><topic>Wound Infection - etiology</topic><topic>Wound Infection - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harvey, Somer</creatorcontrib><creatorcontrib>Brad Hall, A.</creatorcontrib><creatorcontrib>Wilson, Kayla</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harvey, Somer</au><au>Brad Hall, A.</au><au>Wilson, Kayla</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of an emergency medicine pharmacist on initial antibiotic prophylaxis for open fractures in trauma patients</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2018-02</date><risdate>2018</risdate><volume>36</volume><issue>2</issue><spage>290</spage><epage>293</epage><pages>290-293</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><abstract>Targeted antibiotic treatment reduces the infection risk of open fractures when soft tissue and bone are exposed to the environment. The risk of infection increases with higher degrees of injury. The Gustilo-Anderson system was developed to identify the degree of injury of open fractures and can be utilized to guide initial antibiotic therapy. Few studies have been published evaluating the potential impact of emergency medicine pharmacists in trauma, and currently no study has evaluated a pharmacist's influence on antibiotic selection and timing for open fractures.
The objective of this study was to determine the impact of an emergency medicine pharmacist on initial antibiotic selection and timing in trauma patients with open fractures.
This was a retrospective cohort study. Trauma alerts with open fractures from May 1, 2014 to June 30, 2016 were eligible for inclusion. The primary outcome was to determine if pharmacist participation during trauma resuscitation was associated with an increased proportion of initial antibiotic selection meeting guideline recommendations. The secondary outcome was the door-to-antibiotic administration time during resuscitation.
Initial prophylactic antibiotic recommendations were met in 81% of trauma resuscitations when a pharmacist was present versus 47% without a pharmacist present (p<0.01). The median door-to-antibiotic time was 14min in the PHARM group versus 20min in the NO-PHARM group (p=0.02).
The participation of an EM pharmacist during initial trauma resuscitation resulted in improved initial antibiotic selection and faster door-to-antibiotic administration times in trauma patients with open fractures.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29079370</pmid><doi>10.1016/j.ajem.2017.10.039</doi><tpages>4</tpages></addata></record> |
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| ispartof | The American journal of emergency medicine, 2018-02, Vol.36 (2), p.290-293 |
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| subjects | Adult Anti-Bacterial Agents - administration & dosage Antibiotic Prophylaxis - methods Antibiotics Classification Drug dosages Drug stores Emergency medical care Emergency medical services Female Florida - epidemiology Follow-Up Studies Fractures Fractures, Open - complications Health risks Humans Incidence Infections Male Middle Aged Open fracture Pharmacist Pharmacists Physicians Prophylaxis Retrospective Studies Trauma Trauma Centers Wound Infection - epidemiology Wound Infection - etiology Wound Infection - prevention & control |
| title | Impact of an emergency medicine pharmacist on initial antibiotic prophylaxis for open fractures in trauma patients |
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