AI Article Synopsis
- The study aimed to find the rates and causes of suboptimal antimicrobial prescriptions given to children upon discharge from a hospital.
- Approximately 19.7% of the 2,593 discharge prescriptions evaluated were deemed suboptimal, mainly due to incorrect durations and dosages.
- The findings highlight that improvements in prescribing practices are needed, particularly through targeted interventions by antimicrobial stewardship programs, as different factors contribute to suboptimal prescriptions based on the type of antimicrobial used.
Article Abstract
Objective: To determine the rate of and factors associated with suboptimal discharge antimicrobial prescribing at a tertiary referral children's hospital.
Design: Retrospective cohort.
Setting: Tertiary referral children's hospital.
Population: All enteral antimicrobial discharge prescriptions at Lucile Packard Children's Hospital Stanford from January 1st, 2021 through December 31st, 2021.
Method: All enteral discharge antimicrobials are routinely evaluated by our antimicrobial stewardship program within 48 hours of hospital discharge. Antimicrobials are determined to be optimal or suboptimal by an antimicrobial stewardship pharmacist after evaluating the prescribed choice of antimicrobial, dose, duration, dosing frequency, and formulation. The rate and factors associated with suboptimal antimicrobial discharge prescribing were evaluated.
Results: Of 2,593 antimicrobial prescriptions ordered at discharge, 19.7% were suboptimal. Suboptimal prescriptions were due to incorrect duration (72.2%), dose (31.0%), dose frequency (23.3%), drug choice (6.5%), or formulation (5.7%). In total, 87.2% of antimicrobials for perioperative prophylaxis and 13.5% of treatment antimicrobials were suboptimal. Antimicrobials with the highest rate of suboptimal prescriptions were amoxicillin-clavulanate (40.7%), clindamycin (36.6%), and cephalexin (36.6%).
Conclusion: Suboptimal antimicrobial discharge prescriptions are common and present an opportunity for antimicrobial stewardship programs during hospital transition of care. Factors associated with suboptimal prescriptions differ by antimicrobial and prescribed indication, indicating that multiple stewardship interventions may be needed to improve prescribing.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10753499 | PMC |
| http://dx.doi.org/10.1017/ash.2023.488 | DOI Listing |
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