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Abstract Objective: The primary objective was to determine the rate of clinical actions taken post-discharge on updated microbiology results by an ID pharmacist-led team. Secondary objectives were to describe the microbiology results requiring intervention, characterize interventions by type and severity, and determine time from result to clinical review. Design: Retrospective cohort study. Setting: Four hospitals within Mayo Clinic, including two large academic centers and two Mayo Clinic Health System sites. Participants: Adult patients at four sites within Mayo Clinic from 1/1/2019 to 2/28/2023. Eligible patients had a hospitalization with an ID consult and an updated microbiology result reported after discharge. Intervention: Pharmacists reviewed a report of selected patients with microbiology tests that resulted post-discharge within the last 24–96 hours. Interventions were recorded electronically in real-time by the pharmacist. Of those patient encounters with an intervention, a sample of 200 patient encounters was randomly selected for detailed chart abstraction. Results: A total of 6,792 encounters with at least one microbiology result reviewed post-discharge were identified. Of these encounters, 1977 (29%) had at least one resulting intervention. Median time from test update to clinical review was 27.2 hours (IQR 21.6–69.6). The highest severity ratings, in which failure to intervene may have resulted in patient harm, were assigned to the intervention in 28% of cases. Conclusions: For patients seen by an inpatient ID consult service, a post-hospital discharge microbiology result review process performed by ID-trained pharmacists effectively addressed abnormal results during the transition of care. Similar processes may be considered at other institutions.

Outpatient parenteral antimicrobial therapy (OPAT) has been widely used in clinical practice for many decades because of its associated cost savings, reductions in inpatient hospital days, and decreases in hospital-associated infections. Despite this long history, evolving practice patterns and new drug delivery devices continue to present challenges as well as opportunities for clinicians when designing appropriate outpatient antimicrobial regimens. One such change is the increasing use of extended and continuous infusion (CI) of antimicrobials to optimize the achievement of pharmacokinetic and pharmacodynamic targets. Elastomeric devices are also becoming increasingly popular in OPAT, including for the delivery of CI. In this article, we review the clinical evidence for CI in OPAT, as well as practical considerations of patient preferences, cost, and antimicrobial stability.