A Small, Single-Center Community Hospital's Approach to Antimicrobial Stewardship in the Treatment of Patients with Escherichia coli Bacteremia

Abstract

Purpose: Inaccurate findings from antimicrobial susceptibility testing (AST), high expenses, and a lack of funding are just a few of the
problems that pharmacist-led antimicrobial stewardship initiatives might face. In particular, resistance to gram-negative pathogens has
grown since the COVID-19 pandemic. The majority of infections in a little community hospital with only one center are gram negative,
with Escherichia coli infections being the most common. Consequently, the purpose of this research is to examine the pandemic's effects
on antimicrobial stewardship initiatives aimed at fighting Escherichia coli and other ESBL pathogens, as well as the burden of gramnegative bacteremia.
Methods: Patients from a local community hospital who were 18 years old or older were examined in a retrospective cohort study. If
patients' blood cultures did not show a positive result for Escherichia coli and antibiotics were not started while they were in the hospital,
they were not included in the study. Determining the duration of hospital stay was the main goal. Antibiotic de-escalations, antibiotic
duration, time to final antibiotic treatment, serum procalcitonin levels, blood culture availabilities, MIC breakpoints, and Clostridioides
difficult occurrences are critical secondary outcomes. Among the seventy-four individuals diagnosed with gram-negative bacteremia, 41
tested positive for Escherichia coli. The duration of stay for patients with Escherichia coli bacteremia who remained in the intensive care
unit was 13.6 days, according to the primary endpoint statistics. The average duration of stay for patients with bacteremia caused by
Escherichia coli in a non-intensive care unit