Methods: In this retrospective review (January 2012-December 2013) from a large academic center in New York City, we assessed weekly start orders (combined and separate) of cefepime, imipenem, piperacillin/tazobactam, ertapenem, ceftriaxone, ciprofloxacin and levofloxacin in July and August and compared them to the preceding (weeks 1-26) and subsequent weeks (weeks 36-52) for each calendar year. Changes in antibiotic orders in Jully and August were first assessed without formal testing, followed by segmented regression analysis.
Results: Unexpectedly, the number of weekly orders of combined antibiotics decreased in July and August compared to previous weeks (-1.9% in 2012 and -2.1% in 2013) while slightly increasing in September-December 2012 (+1.2%) and decreasing in September-December 2013 (-1.1%). The most substantial decrease in July and August was seen for imipenem (-28.5% in 2012; -13.0% in 2013). Segmented regression analysis noted no significant differences in weekly orders of antibiotics (both separate and combined) in July and August when compared to weeks 1-26 and weeks 36-52. A sensitivity analysis using daily orders instead of weekly orders demonstrated no significant differences in antibiotic start orders in July and August.
Conclusion: Despite inexperienced physicians, a decrease of antibiotic orders, mainly imipenem, was noted in July and August of 2012 and 2013. This demonstrates that a fully staffed and well-supported ASP could potentially affect prescribing practices and counteract the “July Effect”.
J. Poeran, None
R. Hiensch, None
M. Mazumdar, None
G. Patel, None
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