P-1811. Impact of Hemo-Alert Program on Appropriate Antimicrobial Therapy in Hospitalized Patients with Bacteremia: Results from a Quasi-experimental Study

Abstract Background Hemo-Alert program is an antimicrobial stewardship strategy, designed to shorten the time to appropriate antimicrobial therapy in bacteremic patients. Methods Eligible subjects were all hospitalized patients with at least one positive hemoculture. The standard of care included a prompt notification of positive hemoculture via a phone call. However, the final identification and susceptibility results need to be individually retrieved. The Hemo-alert program included a prompt notification of final identification and susceptibility results via a direct SMS to physician and by placing results on patient’s medical chart. Appropriateness of antimicrobial therapy was determined by two independent infectious disease specialists. Antimicrobial therapy for colonization, too-broad or too-narrow regimen were considered inappropriate. Results There were 150 subjects in the pre-implementation group and 150 subjects in the post-implementation group. Approximately half of both groups (pre vs. post; p-value) were male (50.7% vs. 48.7%; p=0.73) with a comparable mean age (66.14±17.13 vs. 68.57±14.41; p=0.18). The three leading causative pathogens were Escherichia coli (24.0% vs. 26.7%; p=0.60), followed by Klebsiella pneumoniae (14.0% vs. 16.7%; p=0.52), and Staphylococcus aureus (9.3% vs. 10.7%; p=0.70). The proportion of appropriate antimicrobial therapy within the first 72 hours was significantly higher in the post-implementation group (22.7% vs. 34.0%; p=0.03). Good clinical response was significantly higher in the post-implementation group (74.0% vs. 85.3%; p=0.02). Furthermore, the 28-day mortality was comparable between the two groups (24.0% vs. 18.0%; p=0.20). Conclusion Our study confirmed the positive impact of the Hemo-Alert program on the appropriateness of antimicrobial therapy and treatment response among bacteremic patients. Disclosures All Authors: No reported disclosures