Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-25T20:58:10.846Z Has data issue: false hasContentIssue false

Antibiotic overuse after discharge from medical short-stay units

Published online by Cambridge University Press:  24 August 2021

Nathaniel S. Soper*
Affiliation:
Division of Hospital Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan
Abhinav J. Appukutty
Affiliation:
Department of Internal Medicine, Northwestern Medicine, Chicago, Illinois
David Paje
Affiliation:
Division of Hospital Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan
Lindsay A. Petty
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan
Scott A. Flanders
Affiliation:
Division of Hospital Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan
Qisu Zhang
Affiliation:
Division of Hospital Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan
Jennifer K. Horowitz
Affiliation:
Division of Hospital Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan
Valerie M. Vaughn
Affiliation:
Division of General Internal Medicine, Department of Internal Medicine, University of Utah Medical School, Salt Lake City, Utah
*
Author for correspondence: Nathaniel S. Soper, E-mail: nssoper@med.umich.edu

Abstract

Of 100 patients discharged from short-stay units (SSUs) with antibiotics, 47 had a skin and soft-tissue infection, 22 had pneumonia, and 21 had a urinary tract infection. Among all discharge antibiotic prescriptions, 78% involved antibiotic overuse, most commonly excess duration (54 of 100) and guideline discordant selection (44 of 100).

Type
Concise Communication
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ross, MA, Hockenberry, JM, Mutter, R. Protocol-driven emergency department observation units offer savings, shorter stays, and reduced admissions. Health Aff 2013;32:21492156.Google ScholarPubMed
Yong, TY, Li, JYZ, Roberts, S. et al. The selection of acute medical admissions for a short-stay unit. Intern Emerg Med 2011;6:321327.Google ScholarPubMed
Yogo, N, Haas, MK, Knepper, BC, et al. Antibiotic prescribing at the transition from hospitalization to discharge: a target for antibiotic stewardship. Infect Control Hosp Epidemiol 2015;36:474478.Google ScholarPubMed
Vaughn, VM, Gandhi, TN, Chopra, V, et al. Antibiotic overuse after hospital discharge: a multi-hospital cohort study. Clin Infect Dis 2020. doi: 10.1093/cid/ciaa1372.Google Scholar
Sullivan, T, de Barra, E. Diagnosis and management of cellulitis. Clin Med (Lond) 2018;18:160163.Google ScholarPubMed
Sanchez, GV, Hersh, AL, Shapiro, DJ, Cawley, JF, Hicks, LA. Outpatient antibiotic prescribing among united states nurse practitioners and physician assistants. Open Forum Infect Dis 2016;3(3):ofw168.CrossRefGoogle ScholarPubMed
Bork, JT, Claeys, KC, Heil, EL, et al. A propensity score matched study of the positive impact of infectious diseases consultation on antimicrobial appropriateness in hospitalized patients with antimicrobial stewardship oversight. Antimicrob Agents Chemother 2020;64:e00307e00020.Google ScholarPubMed
Standiford, HC, Chan, S, Tripoli, M, et al. Antimicrobial stewardship at a large tertiary care academic medical center: cost analysis before, during, and after a 7—year program. Infect Control Hosp Epidemiol 2012;33:338345.Google Scholar
Arensman, K, Dela-Pena, J, Miller, JL, et al. Impact of mandatory infectious diseases consultation and real-time antimicrobial stewardship pharmacist intervention on staphylococcus aureus bacteremia bundle adherence. Open Forum Infect Dis 2020;7(6):ofaa184.Google ScholarPubMed
Kuo, YF, Goodwin, JS, Chen, NW, Lwin, KK, Baillargeon, J, Raji, MA. Diabetes mellitus care provided by nurse practitioners vs primary care physicians. J Am Geriatr Soc 2015;63:19801988.Google ScholarPubMed
Supplementary material: File

Soper et al. supplementary material

Soper et al. supplementary material

Download Soper et al. supplementary material(File)
File 6.2 MB