Decreasing the Time to Oral Antibiotics in a University Hospital Pediatric Emergency Department.

Objectives: To compare time to administration of oral antibiotics in the pediatric emergency department (ED) when antibiotics are stored in the pediatric ED versus when they were dispensed by central pharmacy services within an academic medical center.

Methods: This was a retrospective review of patients who received a one-time dose of oral antibiotics within the pediatric ED and were subsequently discharged home. Two 3-month time periods were compared to determine the metrics of providing oral antibiotics before and after these medications were stocked in the pediatric ED automated dispensing cabinet (ADC). The primary outcome was to compare the time to administration. Secondary outcomes were to assess wastage of stocked medications and time to ED discharge.

Results: In the ADC time period (n = 74), the median time to administration was 17.5 minutes versus 57 minutes in the central pharmacy time period (n = 34) (p < 0.001). The ED length of stay during the ADC time period was 188.5 minutes versus 228.5 minutes (p = 0.094). 35.4% of doses from the ADC expired resulting in a wholesale acquisition cost of $53.14 wasted.

Conclusion: Stocking commonly used oral antibiotics in the pediatric ED led to a significant decrease in the time to medication administration. This decreased time to administration has the potential to lead to improved patient and nursing satisfaction. Routine surveillance is needed after implementation to ensure compliance and to minimize wastage.