Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-23T04:50:13.892Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of Automatic Orders to Discontinue Vancomycin Therapy on Vancomycin Use in an Antimicrobial Stewardship Program

Published online by Cambridge University Press:  02 January 2015

Denise M. Connor ,
Shawn Binkley ,
Neil O. Fishman ,
Leanne B. Gasink ,
Darren Linkin  and
Ebbing Lautenbach
Denise M. Connor
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia
Shawn Binkley
Affiliation:
Department of Pharmacy, University of Pennsylvania School of Medicine, Philadelphia
Neil O. Fishman
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia
Leanne B. Gasink
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia
Darren Linkin
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia
Ebbing Lautenbach*
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia
*
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 825 Blockley Hall, 423 Guardian Dr., Philadelphia, PA 19104-6021 ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

We examined the possible unintended consequences of a 72-hour automatic order to discontinue vancomycin therapy in an antimicrobial stewardship program (ASP). Of 120 patients, 11 had vancomycin therapy discontinued at 72 hours without a call to the ASP, and 7 experienced a treatment interruption of 6-36 hours. All discontinuation of therapy was considered appropriate, and the 7 treatment interruptions did not have clear clinical consequences. Only one-third of patients had ASP stickers that warned of impending discontinuation of vancomycin therapy placed appropriately in the medical record.

Type
Concise Communications
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 12 , December 2007 , pp. 1408 - 1410
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Livermore, DM. Can better prescribing turn the tide of resistance? Nat Rev Microbiol 2004;2:73–78.Google Scholar
2.Harbarth, S, Samore, M. Antimicrobial resistance determinants and future control. Emerg Infect Dis 2005;11:794–801.Google Scholar
3.Patterson, JE. Antibiotic utilization: is there an effect on antimicrobial resistance? Chest 2001;119(suppl 2):426S–430S.CrossRefGoogle ScholarPubMed
4.MacDougall, C, Polk, RE. Antimicrobial stewardship programs in health care systems. Clin Microbiol Rev 2005;18:638–656.CrossRefGoogle ScholarPubMed
5.Paterson, DL. The role of antimicrobial management programs in optimizing antibiotic prescribing within hospitals. Clin Infect Dis 2006;42(suppl 2):S90–S95.CrossRefGoogle ScholarPubMed
6.Dellit, TH, Owens, RC, McGowan, JE Jr, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 2007;44:159–177.CrossRefGoogle Scholar
7.Guglielmo, BJ, Dudas, V, Maewal, I, et al. Impact of a series of interventions in vancomycin prescribing on use and prevalence of vancomycin-resistant Enterococci. Jt Comm J Qual Patient Saf 2005;31:469–475.Google Scholar
8.Gross, R, Morgan, AS, Kinky, DE, Weiner, M, Gibson, GQ, Fishman, NO. Impact of a hospital-based antimicrobial management program on clinical and economic outcomes. Clin Infect Dis 2001;33:289–295.CrossRefGoogle ScholarPubMed
9.Recommendations for preventing the spread of vancomycin resistance of the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep 1995;44(RR12):1–13.Google Scholar