225. Antimicrobial Stewardship Program Interventions Targeting Intravenous Vancomycin Use at a Community Hospital Improves Prescribing and Safety

Background Intravenous vancomycin (VAN) continues to be a workhorse for suspected or documented methicillin-resistant Staphylococcus aureus (MRSA) infections. VAN over-prescribing, and suboptimal dosing or monitoring can be detrimental to efficacy, safety, and resource utilization. A local antimicrobial stewardship program (ASP) was implemented in September 2015 as an expansion of a pre-existing health-system ASP. The local ASP included an infectious diseases (ID) pharmacist, partial FTE ID physician, ASP software, and a goal to decrease inappropriate vancomycin use and improve safety. Methods We performed a serial cross-sectional study assessing the impact of ASP interventions on VAN consumption and AKI incidence at a single-center community hospital from October 2015 through March 2018. ASP interventions included a revised vancomycin dosing and monitoring guideline, education, and prospective audit and feedback by clinical pharmacists working under the guidance of ID pharmacist and physician. Antibiotic days of therapy (DOT) were tracked and reported quarterly with Theradoc® software. Acute kidney injury was defined as an increase of ≥0.5 mg/dL or 50% in serum creatinine from baseline in all hospitalized patients with baseline