Assessing an intervention to improve the safety of automatic stop orders for inpatient antimicrobials

• Main Authors: Lauren Dutcher (Author), Alyssa Yeager (Author), Yevgeniy Gitelman (Author), Steven Morgan (Author), Jillian Dougherty Laude (Author), Shawn Binkley (Author), Amanda Binkley (Author), Christo Cimino (Author), Lindsay McDonnell (Author), Stephen Saw (Author), Valerie Cluzet (Author), Ebbing Lautenbach (Author), Keith W. Hamilton (Author)
• Format: Book
• Published: Elsevier, 2020-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Summary: Background: Automatic stop orders (ASOs) for antimicrobials have been recommended as a component of antimicrobial stewardship programs, but may result in unintentional treatment interruption due to failure of providers to re-order an antimicrobial medication. We examined the impact of a multifaceted intervention designed to reduce the potential harms of interrupting antimicrobial treatment due to ASOs. Methods: An intervention was implemented that included pharmacist review of expiring antimicrobials as well as provider education to encourage use of a long-term antimicrobial order set for commonly used prophylactic antimicrobials. Pharmacist interventions and antimicrobial re-ordering was recorded. Percent of missed doses of a commonly used prophylactic antimicrobial, single strength co-trimoxazole, was compared pre- and post-intervention using a chi-squared test. Results: From November 1, 2015 to November 30, 2016, there were 401 individual pharmacist interventions for antimicrobial ASOs, resulting in 295 instances of antimicrobial re-ordering. The total percent of presumed missed single strength co-trimoxazole doses was reduced from 8.4% to 6.2% post-intervention (P<0.001). Conclusions: This study found that a targeted intervention was associated with a reduction in unintended antimicrobial treatment interruption related to ASOs.

Item Description

2590-0889
10.1016/j.infpip.2020.100062