Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF November 2, 2018 | Archived Issues

Meetings and Events

Regenerative Cartilage Update
Nov. 6

A Night Remembering Leonard Nimoy
Nov. 8

Mending Kids 7th Annual Wings Gala
Nov. 17

These events and more can be found in the medical staff calendar on the Cedars-Sinai website.


Grand Rounds


Upcoming CME Conferences


Milestones

Do you know of a significant event in the life of a medical staff member? Please let us know, and we'll post these milestones in Medical Staff Pulse. Also, feel free to submit comments on milestones, and we'll post the comments in the next issue.

Submit your milestones and comments.

Share Your News

Won any awards or had an article accepted for publication? Share your news about professional achievements and other items of interest.

Click here to share your news

New CS-Link Panels Help Guide Antibiotics Use

Over the last year, Cedars-Sinai’s Antimicrobial Stewardship team has developed antibiotic treatment panels for various indications.

The goal of these new indication- and duration-based panels, which are based on Cedars-Sinai empiric treatment guidelines, is to ensure the use of the right antibiotic for the right patient at the right time for the right duration by providing clinicians with recommendations when they order antibiotics for a particular infection.

The initiative is part of the Antimicrobial Stewardship Program's ongoing efforts to help reduce the misuse, overuse and underuse of antimicrobials, which can lead to resistance, C. difficile infections, increased length of stay and readmissions.

"The Antimicrobial Stewardship Committee regularly updates empiric antibiotic treatment recommendations for common indications; however, we needed to find a way to make them more accessible to clinicians," said Jonathan Grein, MD, director of the Department of Hospital Epidemiology. "With these antibiotic panels through CS-Link™, we’re making it intuitive and easy for clinicians to order antibiotics in a way that is consistent with our recommendations based on resistance patterns here at the hospital."

The panels are integrated into the existing ordering workflow and aim to improve the appropriate use of antimicrobials. It is estimated that at least 30 percent of antimicrobials given on inpatient units have an opportunity for stewardship.

How Do They Work?

Treatment panels for UTI, pneumonia, skin/soft tissue infections and intra-abdominal infections are now available in CS-Link. The panels can be found by searching for these four indications as well as commonly used synonyms. The panels will also appear if clinicians search for the 11 most frequently used antimicrobials.

For example, if a clinician searches for "cefepime" in an effort to treat a urinary tract infection, CS-Link will present a treatment panel option titled "UTI Treatment Panel." Within the panel, various options are presented to help the clinician further define the nature of the infection.

The UTI panel asks the clinician to select "Community Acquired UTI" or "Hospital or Nursing Home Acquired UTI," and then recommends particular antibiotic therapies based on that selection. In the case of a community-acquired UTI, the recommended empiric therapy displayed in CS-Link can be seen below:

Panel-Example480.jpg

"Instead of a physician finding an antibiotic to fit the infection they are treating, these panels provide the antibiotics that have been identified as the right antibiotics based on our own internal data, as well as the type of infection the patient has," said Rita Shane, PharmD, chief pharmacy officer and professor of medicine. "It makes the selection of the right antibiotic for the right duration for the right infection a one-step process."

The Antimicrobial Stewardship team will share more information on these panels during U.S. Antibiotic Awareness Week, Nov. 12-18, 2018, an annual observance raising awareness of the threat of antibiotic resistance and the importance of appropriate antibiotic use nationwide.

The Antimicrobial Stewardship Program also is focused on improving the accuracy of documented allergies. Research has shown that 90 percent of patients with documented penicillin allergies are not truly allergic. These patients could potentially still receive penicillin-related antibiotics instead of broad-spectrum antibiotics that may lead to resistance or treatment failure.

For more information on the treatment panels, or the Antimicrobial Stewardship Program, contact an antimicrobial stewardship pharmacist at 310-423-5352.