“Diagnostic Stewardship Is Always an Area of Need”

Antimicrobial resistance, a consistent cause for concern, was heightened by the COVID-19 pandemic. As healthcare workers strugg led to treat virus patients, antibiotics were deployed frequently and unnecessarily.

Therefore, Erica Stohs, MD, MPH, explains, antimicrobial stewardship became more important than ever.

Stohs is an Associate Program Director of the Antimicrobial Stewardship Program at the University of Nebraska Medical Center. At the IDWeek 2022 conference, Stohs presented research centering around the BioFire FilmArray Pneumonia (PN) Panel that she and her team implemented in 2020.

The study coincided with that year’s peak of the COVID-19 pandemic, so the team examined how the test was utilized in COVID-19 patients, and whether it affected antibiotic use.

Conducting this research in COVID-19 patients coinfected with pneumonia was vital, Stohs explained, as there was a significant overuse of antimicrobials in this cohort. The investigators determined what they were isolating, and whether secondary bacterial pneumonia was actually occurring.

“While these were mostly community-acquired organisms,” Stohs explained, “the empiric antibiotics used were for hospital-acquired organisms, which was not necessary.” She emphasized the importance of the work her team did to deescalate patients to targeted therapy or stop antibiotics entirely.

“Diagnostic stewardship is always an area of need,” Stohs said. She explained this is especially true for pneumonia, which can have limited culture data.

“By far, the most significant finding was that in almost 50% of patients who were on vancomycin empirically, it could be stopped.”

Stohs was a panelist for the discussion “Challenging Cases in Transplant Infectious Diseases,” presented at IDWeek 2022, held October 19-23, 2022, in Washington, D.C.