ARRS 2022 Abstracts

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E1402. Assessing Antibiotic Adherence and Improving Antibiotic Stewardship in Common Interventional Radiology Procedures
Authors
  1. Steven Meng; University of Rochester Medical Center
  2. Devang Butani; University of Rochester Medical Center
  3. Andrew Cantos; University of Rochester Medical Center
Objective:
In 2018, JVIR updated its guidelines regarding peri-procedural antibiotics. However, many institutions are slow to adopt these new guidelines. Antibiotic-resistant bacteria and sepsis are serious concerns, due in part to incorrect usage of antibiotics. Here, we assess institutional adherence to 2018 JVIR guidelines for the purpose of improving antibiotic stewardship.

Materials and Methods:
Institutional review board approval was obtained. Eight hundred cases were retrospectively identified, and charts were reviewed for a 10-month time period following the release of guidelines. Inclusion criteria for the study was adults aged 21 years or older undergoing mediport placement, tunneled central line (TCL) placement, nephrostomy tube change, or biliary or cholecystostomy tube change. Exclusion criteria included immunocompromised and pregnant individuals, as 2018 guidelines may not fit these populations. Guideline adherence for each procedure was recorded as a percentage; timing of the antibiotic usage was also recorded and compared to the guidelines (within 60 minutes prior to incision).

Results:
In total, 49 mediport placements, 118 TCL placements (44 hemodialysis [HD] and 74 non-hemodialysis), 100 nephrostomy changes, and 82 biliary tube changes were included. Antibiotics were used in 83.6% (41/49) of mediport patients, 11.3% (5/44) of non-HD TCL patients, 20.3% (15/74) of HD TCL patients, 55% (55/100) nephrostomy tube changes, and 65.5% (55/84) of biliary or cholecystostomy tube changes. Out of those given prophylaxis, guideline-recommended antibiotics were used in 100% (41/41) of mediports, 100% (20/20) of TCL (non-HD and HD), 9.1% (5/55) of nephrostomy tube changes, and 1.8% (1/55) of biliary tube changes. Guideline-recommended timing was followed in 75.3% across all cases (ranging from 72.2% in mediports to 79.3% in biliary and cholecystostomy tube changes).

Conclusion:
This study of antibiotic practices at our institution revealed that antibiotic usage is not fully up to date with 2018 guidelines. For mediports and non-HD TCL placement and nephrostomy tube changes, institutional changes should be made to reduce peri-procedural antibiotic use, as antibiotics are no longer recommended for these procedures. For HD TCL placement and biliary/cholecystostomy tube changes, proper adherence to recommended prophylactic antibiotics should be followed. In addition, education about the correct antibiotic timing should be emphasized to increase compliance with guidelines.