Methods: A retrospective study was conducted to evaluate whether prescribers chose the indication matching the patient’s condition at order entry. Infection diagnosis was determined by reviewing the electronic medical record (EMR), including cultures. Inclusion criteria were: first-dose, targeted antibiotics (e.g. cefepime, meropenem, piperacillin-tazobactam, and vancomycin), age >18, and admitted to an intensive care unit (ICU). Patients on multiple antibiotics had all first doses included.
Results: 171 orders were collected from the last week of June, July, and August of 2014. Of those, 5 (3%) orders were entered as “bacteremia” without positive blood cultures. For 166 (97%) orders, the chosen indication matched documentation in the EMR. The option “empiric” was selected in 50% of the orders, though patients may have had symptoms of a specific infection.
Conclusion: Our findings suggest that prescribers are documenting an accurate indication when selecting antibiotics. Although “empiric” may have been chosen for patients that exhibited signs of a specific infection, these ICU patients may have had multiple sources, limiting confirmation of diagnosis at the time of prescribing. This function seems to be an accurate tool for pharmacists and antimicrobial stewardship programs evaluating antibiotic selection, dose, and appropriateness.
E. Cano, None
Y. Kuyumjian, None
L. Abbo, None
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