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

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 mu...

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Main Authors: Lauren Dutcher, Alyssa Yeager, Yevgeniy Gitelman, Steven Morgan, Jillian Dougherty Laude, Shawn Binkley, Amanda Binkley, Christo Cimino, Lindsay McDonnell, Stephen Saw, Valerie Cluzet, Ebbing Lautenbach, Keith W. Hamilton
Format: Article
Language:English
Published: Elsevier 2020-06-01
Series:Infection Prevention in Practice
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590088920300263
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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.
ISSN:2590-0889