Improving Utilization of Sputum Culture in Patients Hospitalized with Pneumonia: A Quality Improvement Initiative.

BACKGROUND: Sputum cultures are essential for guiding targeted antibiotic therapy; however, they are often underutilized. This quality improvement initiative aimed to enhance sputum culture ordering through an antimicrobial stewardship pharmacist-led intervention. METHODS: A retrospective review of pneumonia hospitalizations from January 2021 through December 2022 evaluated the impact of a policy change allowing antimicrobial stewardship pharmacists to order sputum cultures. Statistical analyses compared preintervention and postintervention sputum culture ordering rates, adjusting for patient demographics, hospital admission location, and other covariates. RESULTS: Sputum culture orders increased from 36% before the intervention to 50% after the intervention, with a 29% higher likelihood of sputum culture ordering after the intervention (risk ratio, 1.29; 95% CI, 1.19-1.38; P < .001). CONCLUSIONS: This intervention demonstrates the potential for antimicrobial stewardship programs to improve adherence to guideline-based practices through pharmacist-led initiatives.