32 - Peri-procedural Antibiotic Stewardship in Interventional Radiology

Purpose: To assess current peri-procedural antibiotic administration practices within our IR department and create departmental guidelines aligned with SIR standards to optimize antibiotic stewardship, with aims to reduce improper antibiotic usage and enhance staff comfort with antibiotic selection.

Materials and Methods: A peri-procedure antibiotic guide was created based on antibiotic prophylaxis practice parameters published by the SIR. Physical and electronic copies of the guide were distributed to IR staff. IR outpatient procedure documentation was reviewed from a 3-month pre-intervention period, from September to November 2022, and analyzed to determine antibiotic administration consistency with the created antibiotic guide.

Following the implementation of the antibiotic guide, IR outpatient procedure documentation was reviewed from a 3-month post-intervention period, from May to July 2023, and analyzed to determine antibiotic administration consistency with the guide.

Pre- and post-intervention surveys assessing staff comfort and knowledge in peri-procedure antibiotic selection were administered via  anonymous online surveys to all physicians, advanced practice providers, and nursing staff within the IR department. The surveys included multiple-choice questions in which respondents chose an antibiotic regimen based on a clinical scenario.

Results: Antibiotic selection and use were reviewed in 686 outpatient IR procedures over the 3-month pre-intervention period. Overall, 76.4% (524/686) of the pre-intervention procedures were in accordance with the antibiotic guide. Following the intervention, antibiotic selection and use from 704 outpatient procedures during the 3-month post-intervention period were reviewed, which demonstrated improved adherence of 93.8% (660/704) to the established guide.

Fifty-one pre-intervention survey respondents, on average, reported a comfort level of 5.7/10 when selecting antibiotics for procedures, and a comfort level of 4.3/10 for antibiotic selection in patients with antibiotic allergies, with improvement in comfort levels to 7.4/10 and 6.4/10, respectively, on the post-intervention survey (27 respondents). The post-intervention survey also demonstrated improvement in the percentage of correct answers to the clinical scenario MCQs to 71%, from 50% on the pre-intervention survey.

Conclusion: Standardized peri-procedural antibiotic administration guidelines promote antibiotic stewardship and improve staff comfort and knowledge when choosing peri-procedure antibiotics within the IR department.