Mandatory discontinuation dates, documentation of indications have no impact on the duration of antibiotic therapy

Shorter antibiotic treatment times have been shown to be just as effective as longer treatment times for many infections. Shorter treatment times also resulted in fewer adverse events.

Recently, a community hospital added a computerized physician order entry system (CPOE) in the electronic health record, which requires an indication, as well as the length of treatment to be documented on all antibiotic orders prior to submitting the medication. the order for verification by the pharmacist.

Investigators from the North Florida Regional Medical Center set out to determine whether implementing this system would reduce the length of treatment in hospitalized patients with bacterial pneumonia.

The data were presented to the 23rd 2021 Virtual Sessions of the Making a Difference in Infectious Disease Meeting.

The retrospective, pretest-post-test, interrupted time series, quasi-experimental study included 138 patients, of which 56 were included in the pre-intervention group and 82 were included in the post-intervention group.

Patients received antibiotic therapy ≥ 48 hours for bacterial pneumonia between April 1, 2016 and May 1, 2016 and April 1, 2017 to May 1, 2017. The primary endpoint of the study was the duration of antibiotic treatment. prescribed. for bacterial pneumonia.

The results of the study demonstrated that there was no difference in the results of length of hospital stay, 30-day readmission, 30-day in-hospital mortality or l incidence of C. difficile infection in hospital.

In addition, the median duration of antibiotic therapy in the pre-intervention group was 4.4 days (IQR 2.9-5.9) and the duration in the post-intervention group was 4.5 days (IQR: 3.5-5.2).

“The implementation of the mandatory indication and default withdrawal dates did not have an impact on the duration of antibiotic therapy in a hospital setting for patients with bacterial pneumonia. Requiring shutdown dates also did not cause harm, ”the authors wrote. “The unmeasurable impacts of the required documentation include the ability to clinically assess antibiotic orders, assess the appropriateness of antibiotic selection by indication, and dose adjustments based on indication.”


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