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Evaluation of an electronic antimicrobial time-out on antimicrobial utilization at a large health system

Published online by Cambridge University Press:  17 May 2019

Steven R. Richardson
Affiliation:
Department of Pharmacy, Kaweah Delta Medical Center, Visalia, California
Elizabeth A. Neuner*
Affiliation:
Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio
Vasilios Athans
Affiliation:
Department of Pharmacy, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Pavithra Srinivas
Affiliation:
Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio
Jill Wesolowski
Affiliation:
Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio
Steven M. Gordon
Affiliation:
Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio
Thomas G. Fraser
Affiliation:
Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio
*
Author for correspondence: Elizabeth A. Neuner, E-mail: neunere@ccf.org

Abstract

We evaluated the impact of an electronic health record based 72-hour antimicrobial time-out (ATO) on antimicrobial utilization. We observed that 6 hours after the ATO, 21% of empiric antimicrobials were discontinued or de-escalated. There was a significant reduction in the duration of antimicrobial therapy but no impact on overall antimicrobial usage metrics.

Type
Concise Communication
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION: These data were presented in part at IDWeek on October 4, 2018, in San Francisco, California.

References

CDC. Core Elements of Hospital Antibiotic Stewardship Programs. Atlanta, GA: US Department of Health and Human Services, CDC; 2014.Google Scholar
Barlam, TF, Cosgrove, SE, Abbo, LM, et al. Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis 2016;62:5177.CrossRefGoogle Scholar
Lee, TC, Frenette, C, Jayaraman, D, Green, L, Pilote, L. Antibiotic self-stewardship: trainee-led structured antibiotic time-outs to improve antimicrobial use. Ann Intern Med 2014;161:S53S58.CrossRefGoogle ScholarPubMed
Graber, CJ, Jones, MM, Glassman, PA, et al. Taking an antibiotic time-out: utilization and usability of a self-stewardship time-out program for renewal of vancomycin and piperacillin-tazobactam. Hosp Pharm 2015;50:10111024.CrossRefGoogle ScholarPubMed
Jones, M, Butler, J, Graber, CJ, et al. Think twice: a cognitive perspective of an antibiotic timeout intervention to improve antibiotic use. J Biomed Inform 2017;71S:S22S31.CrossRefGoogle ScholarPubMed
Lesprit, P, Duong, T, Girou, E, Hemery, F, Brun-Buisson, C. Impact of a computer-generated alert system prompting review of antibiotic use in hospitals. J Antimicrob Chemother 2009;63:10581063.CrossRefGoogle ScholarPubMed
Weiss, CH, Dibardino, D, Rho, J, Sung, N, Collander, B, Wunderink, RG. A clinical trial comparing physician prompting with an unprompted automated electronic checklist to reduce empirical antibotic utilization. Crit Care Med 2013;41:25632569.CrossRefGoogle Scholar
Thom, KA, Tamma, PD, Harris, AD, et al. Impact of a prescriber-driven antibiotic time-out on antibiotic use in hospitalized patients. Clin Infect Dis 2018. doi: 10.1093/cid/ciy852.Google ScholarPubMed
NHSN antimicrobial use and resistance module protocol. Centers for Diseases Control and Prevention website. http://www.cdc.gov/nhsn/pdfs/pscmanual/11psaurcurrent.pdf. January 2017. Accessed April 11, 2019.Google Scholar
Wang, N, Neuner, EA, Pallotta, AM, et al. Validation and Evaluation of Antimicrobial Orders Indication for Use. Infect Control Hosp Epidemiol 2018;39:243245.CrossRefGoogle ScholarPubMed
Gerber, JS, Hersh, AL, Kronman, MP, Newland, JG, Ross, RK, Metjian, TA. Development and application of an antibiotic spectrum index for benchmarking antibiotic selection patterns across hospitals. Infect Control Hosp Epidemiol 2017;38:993997.CrossRefGoogle ScholarPubMed
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