Posters
Presenting Author Academic/Professional Position
Carlos Luis Alejos
Academic Level (Author 1)
Resident
Discipline/Specialty (Author 1)
Internal Medicine
Academic Level (Author 2)
Staff
Discipline/Specialty (Author 2)
Internal Medicine
Academic Level (Author 3)
Resident
Discipline/Specialty (Author 3)
Internal Medicine
Academic Level (Author 4)
Resident
Discipline/Specialty (Author 4)
Internal Medicine
Academic Level (Author 5)
Resident
Discipline/Specialty (Author 5)
Internal Medicine
Discipline Track
Patient Care
Abstract Type
Research/Clinical
Abstract
Introduction: National guidelines recommend early, targeted diagnostics such as respiratory viral panels, procalcitonin testing, Methicillin resistant staphylococcus aureus (MRSA) nasal swabs, and sputum cultures, for the effective management of pneumonia. However, our retrospective review at a university-affiliated community hospital revealed inconsistent application of these tools. These may contribute to excessive use of broad-spectrum antibiotics, higher costs, and increased antimicrobial resistance. The reason is that we aim to implement a standardized pneumonia order set in the electronic medical record (EMR) to improve diagnostic accuracy and antibiotic stewardship.
Methods: We conducted a retrospective chart review of adult inpatients admitted with community-acquired, hospital-acquired, or ventilator-associated pneumonia from January to June 2025. Patients were identified using ICD-10 codes, and data were abstracted into RED-Cap using a standardized case report form. Variables collected included demographics, pneumonia classification (per American Thoracic Society/ Infectious Diseases Society of America), diagnostic tests, empiric antibiotics, and de-escalation status. Records were analyzed using Stata v18. We calculated test utilization rates and compared length-of-stay distributions using chi-square tests.
Results: Among 496 complete cases, sputum cultures were obtained in 41.9%, MRSA nasal swabs in 32.9%, and respiratory viral panels in only 21.0%. Procalcitonin was measured in 66.2% and blood cultures in 56.9% of eligible patients. Antibiotic de-escalation within 72 hours occurred in 45.6% of cases. De-escalation was associated with significantly shorter hospital stays (χ² = 24.01, p < 0.001).
Conclusions: Underutilization of diagnostics and delayed de-escalation highlight opportunities for improved stewardship. A standardized EMR-based order set may enhance adherence to guidelines and improve outcomes for pneumonia patients.
Presentation Type
Poster
Recommended Citation
Alejos, Carlos Luis; Rojas Huen, Jennifer; Capellan, Joan Beatrice; Serna, Ricardo; Swamy, Tejaswini; and Campo Maldonado, Jose, "Optimizing Antibiotic Stewardship in Pneumonia: Evidence-Based Protocols for Enhanced Treatment and Resistance Reduction in a University-Affiliated Community Hospital" (2025). Research Colloquium. 29.
https://scholarworks.utrgv.edu/colloquium/2025/posters/29
Optimizing Antibiotic Stewardship in Pneumonia: Evidence-Based Protocols for Enhanced Treatment and Resistance Reduction in a University-Affiliated Community Hospital
Introduction: National guidelines recommend early, targeted diagnostics such as respiratory viral panels, procalcitonin testing, Methicillin resistant staphylococcus aureus (MRSA) nasal swabs, and sputum cultures, for the effective management of pneumonia. However, our retrospective review at a university-affiliated community hospital revealed inconsistent application of these tools. These may contribute to excessive use of broad-spectrum antibiotics, higher costs, and increased antimicrobial resistance. The reason is that we aim to implement a standardized pneumonia order set in the electronic medical record (EMR) to improve diagnostic accuracy and antibiotic stewardship.
Methods: We conducted a retrospective chart review of adult inpatients admitted with community-acquired, hospital-acquired, or ventilator-associated pneumonia from January to June 2025. Patients were identified using ICD-10 codes, and data were abstracted into RED-Cap using a standardized case report form. Variables collected included demographics, pneumonia classification (per American Thoracic Society/ Infectious Diseases Society of America), diagnostic tests, empiric antibiotics, and de-escalation status. Records were analyzed using Stata v18. We calculated test utilization rates and compared length-of-stay distributions using chi-square tests.
Results: Among 496 complete cases, sputum cultures were obtained in 41.9%, MRSA nasal swabs in 32.9%, and respiratory viral panels in only 21.0%. Procalcitonin was measured in 66.2% and blood cultures in 56.9% of eligible patients. Antibiotic de-escalation within 72 hours occurred in 45.6% of cases. De-escalation was associated with significantly shorter hospital stays (χ² = 24.01, p < 0.001).
Conclusions: Underutilization of diagnostics and delayed de-escalation highlight opportunities for improved stewardship. A standardized EMR-based order set may enhance adherence to guidelines and improve outcomes for pneumonia patients.
