{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T13:26:09Z","timestamp":1772630769717,"version":"3.50.1"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The implementation of MRSA PCR nasal swabs has been shown to decrease the use of anti-MRSA therapies through faster antibiotic de-escalation in patients with pneumonia. While this benefit has been shown exclusively in Gram-positive therapy, swab results may lead to additional antibiotic de-escalation discussions early on, potentially providing reduced durations or de-escalations of Gram-negative therapy as well.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To determine if early de-escalation discussions prompted by MRSA swab results lead to shorter durations of Gram-negative antibiotic therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective chart review was conducted to compare pneumonia duration of Gram-negative therapy pre- and post-implementation of MRSA nasal swabs. Time to de-escalation, time to conversion to enteral therapy and cost were also compared between the groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Data were collected for 240 patients overall, 120 in each group. The median duration of Gram-negative therapy was 154.0\u2005h in the post-implementation group and 176.4\u2005h in the pre-implementation group (P\u200a=\u200a0.002). There was no significant difference in time to de-escalation (52.7 versus 54.9\u2005h; P\u200a=\u200a0.351) or time to transition from IV to enteral therapy (53.0 versus 57.3\u2005h; P\u200a=\u200a0.289). The median cost of Gram-negative regimens per patient was less expensive in the post-implementation group ($31.36 versus $45.90; P\u200a=\u200a0.002).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>MRSA nasal swabs as an antimicrobial stewardship tool were associated with a reduced overall duration of Gram-negative therapy and Gram-negative antibiotic regimen cost. This introduces an additional benefit of MRSA nasal swabs and further incentivizes their use as an antimicrobial stewardship tool.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkac198","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T05:41:01Z","timestamp":1655962861000},"page":"2557-2560","source":"Crossref","is-referenced-by-count":2,"title":["Duration of Gram-negative antibiotic therapy in patients with pneumonia prior to and after the implementation of MRSA nasal swabs, an antimicrobial stewardship tool"],"prefix":"10.1093","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5175-086X","authenticated-orcid":false,"given":"Bradley S","family":"Troyer","sequence":"first","affiliation":[{"name":"West Virginia University Hospitals, 1 Medical Center Drive , Morgantown, WV , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda Jo","family":"Shigle","sequence":"additional","affiliation":[{"name":"West Virginia University Hospitals, 1 Medical Center Drive , Morgantown, WV , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Kovacic Scherrer","sequence":"additional","affiliation":[{"name":"West Virginia University Hospitals, 1 Medical Center Drive , Morgantown, WV , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"2022082518383549600_dkac198-B1","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.pulmoe.2019.10.003","article-title":"Pneumonia mortality, comorbidities matter?","volume":"26","author":"Hespanhol","year":"2020","journal-title":"Pulmonology"},{"key":"2022082518383549600_dkac198-B2","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1093\/cid\/ciw353","article-title":"Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society","volume":"63","author":"Kalil","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2022082518383549600_dkac198-B3","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and treatment of adults with community-acquired pneumonia: an official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America","volume":"200","author":"Metlay","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"2022082518383549600_dkac198-B4","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.jcrc.2016.11.008","article-title":"Clinical utility of methicillin-resistant Staphylococcus aureus nasal polymerase chain reaction assay in critically ill patients with nosocomial pneumonia","volume":"38","author":"Smith","year":"2017","journal-title":"J Crit Care"},{"key":"2022082518383549600_dkac198-B5","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1007\/s11096-018-0647-3","article-title":"Evaluation of a pharmacy-driven methicillin-resistant Staphylococcus aureus surveillance protocol in pneumonia","volume":"40","author":"Dunaway","year":"2018","journal-title":"Int J Clin Pharm"},{"key":"2022082518383549600_dkac198-B6","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.2146\/ajhp160964","article-title":"Impact of a pharmacist-driven methicillin-resistant Staphylococcus aureus surveillance protocol","volume":"74","author":"Willis","year":"2017","journal-title":"Am J Health Syst Pharm"},{"key":"2022082518383549600_dkac198-B7","first-page":"e6378","article-title":"Impact of a pharmacist-driven methicillin-resistant Staphylococcus aureus polymerase chain reaction nasal swab protocol on the de-escalation of empiric vancomycin in patients with pneumonia in a rural healthcare setting","volume":"11","author":"Dadzie","year":"2019","journal-title":"Cureus"},{"key":"2022082518383549600_dkac198-B8","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1177\/0018578719888906","article-title":"Impact of a pharmacist-driven MRSA nasal PCR protocol on pneumonia therapy","volume":"56","author":"Pham","year":"2021","journal-title":"Hosp Pharm"},{"key":"2022082518383549600_dkac198-B9","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1378\/chest.10-0166","article-title":"Pneumonia due to Pseudomonas aeruginosa","volume":"139","author":"Fujitani","year":"2011","journal-title":"Chest"},{"key":"2022082518383549600_dkac198-B10","doi-asserted-by":"crossref","first-page":"S42","DOI":"10.2146\/ajhp170360","article-title":"Impact of an antimicrobial stewardship program on outcomes in patients with community-acquired pneumonia admitted to a tertiary community hospital","volume":"75","author":"Gordon","year":"2018","journal-title":"Am J Health Syst Pharm"},{"key":"2022082518383549600_dkac198-B11","doi-asserted-by":"crossref","first-page":"e02432-16","DOI":"10.1128\/AAC.02432-16","article-title":"Nasal methicillin-resistant Staphylococcus aureus (MRSA) PCR testing reduces the duration of MRSA-targeted therapy in patients with suspected MRSA pneumonia","volume":"61","author":"Baby","year":"2017","journal-title":"Antimicrob Agents Chemother"},{"key":"2022082518383549600_dkac198-B12","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofab099","article-title":"Discontinuation patterns and cost avoidance of a pharmacist-driven methicillin-resistant Staphylococcus aureus nasal polymerase chain reaction testing protocol for de-escalation of empiric vancomycin for suspected pneumonia","volume":"8","author":"Meng","year":"2021","journal-title":"Open Forum Infect Dis"},{"key":"2022082518383549600_dkac198-B13","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3390\/pharmacy8020101","article-title":"Impact of nasal swabs on empiric treatment of respiratory tract infections (INSERT-RTI)","volume":"8","author":"Huffman","year":"2020","journal-title":"Pharmacy (Basel)"},{"issue":"Suppl 2","key":"2022082518383549600_dkac198-B14","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1086\/511159","article-title":"Infectious Diseases Society of America\/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults","volume":"44","author":"Mandell","year":"2007","journal-title":"Clin Infect Dis"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/77\/9\/2557\/45536540\/dkac198.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/77\/9\/2557\/45536540\/dkac198.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T18:39:45Z","timestamp":1661452785000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/77\/9\/2557\/6613468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,23]]},"references-count":14,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,6,23]]},"published-print":{"date-parts":[[2022,8,25]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkac198","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,9,1]]},"published":{"date-parts":[[2022,6,23]]}}}