Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\27621509
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Hosp+Pharm
2015 ; 50
(11
): 1011-24
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Taking an Antibiotic Time-out: Utilization and Usability of a Self-Stewardship
Time-out Program for Renewal of Vancomycin and Piperacillin-Tazobactam
#MMPMID27621509
Graber CJ
; Jones MM
; Glassman PA
; Weir C
; Butler J
; Nechodom K
; Kay CL
; Furman AE
; Tran TT
; Foltz C
; Pollack LA
; Samore MH
; Goetz MB
Hosp Pharm
2015[Nov]; 50
(11
): 1011-24
PMID27621509
show ga
BACKGROUND: Antibiotic time-outs can promote critical thinking and greater
attention to reviewing indications for continuation. OBJECTIVE: We pilot tested
an antibiotic time-out program at a tertiary care teaching hospital where
vancomycin and piperacillin-tazobactam continuation past day 3 had previously
required infectious diseases service approval. METHODS: The time-out program
consisted of 3 components: (1) an electronic antimicrobial dashboard that
aggregated infection-relevant clinical data; (2) a templated note in the
electronic medical record that included a structured review of antibiotic
indications and that provided automatic approval of continuation of therapy when
indicated; and (3) an educational and social marketing campaign. RESULTS: In the
first 6 months of program implementation, vancomycin was discontinued by day 5 in
93/145 (64%) courses where a time-out was performed on day 4 versus in 96/199
(48%) 1 year prior (P = .04). Seven vancomycin continuations via template (5% of
time-outs) were guideline-discordant by retrospective chart review versus none 1
year prior (P = .002). Piperacillin-tazobactam was discontinued by day 5 in
70/105 (67%) courses versus 58/93 (62%) 1 year prior (P = .55); 9 continuations
(9% of time-outs) were guideline-discordant versus two 1 year prior (P = .06). A
usability survey completed by 32 physicians demonstrated modest satisfaction with
the overall program, antimicrobial dashboard, and renewal templates. CONCLUSIONS:
By providing practitioners with clinical informatics support and guidance, the
intervention increased provider confidence in making decisions to de-escalate
antimicrobial therapy in ambiguous circumstances wherein they previously sought
authorization for continuation from an antimicrobial steward.