Comparison of Antibiotic Dosing Before and After Implementation of an Electronic Order Set.

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  • Additional Information
    • Source:
      Publisher: Thieme Country of Publication: Germany NLM ID: 101537732 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1869-0327 (Electronic) Linking ISSN: 18690327 NLM ISO Abbreviation: Appl Clin Inform Subsets: MEDLINE
    • Publication Information:
      Publication: 2018- : Stuttgart, Germany : Thieme
      Original Publication: Hölderlinstr, Germany : Schattauer
    • Subject Terms:
      Medical Order Entry Systems*; Anti-Bacterial Agents/*therapeutic use; Dose-Response Relationship, Drug ; Humans
    • Abstract:
      Background: To maximize resources, the antimicrobial stewardship program at a pediatric tertiary care hospital made pediatric dosing specific guidance within the electronic health record available to all hospitals within the health system.
      Objective: The objective of this study was to compare the appropriateness of antibiotic dosing before and after the implementation of an electronic intravenous (IV) antibiotic order set.
      Methods: This was a retrospective cohort study evaluating orders from patients younger than 18 years who received cefepime, piperacillin-tazobactam, tobramycin, or gentamicin at 12 health-system hospitals. Antibiotic dosing regimens and order set use were evaluated in patients who received the specified antibiotics during the 6-month time frame prior to and following electronic order set availability at each hospital.
      Results: In the before and after implementation periods, 360 and 387 total antibiotic orders were included, respectively. Most orders were gentamicin (55.8% in the before implementation period and 54.5% in the after implementation period) followed by piperacillin-tazobactam (22.5% in the before period and 22.2% in the after period). Overall, 663 orders were classified as appropriate (88.8%). Appropriateness was similar in the before or after implementation periods (87.8 vs. 89.7%, p  = 0.415). There was a significant difference in appropriateness if a blank order versus the electronic IV antibiotic order set was used (82.8 vs. 90.5%; p  = 0.024).
      Conclusion: No difference in antibiotic appropriateness overall was found in the before and after implementation periods. However, when specifically compared with the appropriateness of dosing when blank order forms were used, dosing was more appropriate when electronic antibiotic order sets were used.
      Competing Interests: Kristen Nichols is a pediatric contributor to LexiComp, the resource used to assess pediatric antibiotic dosing in this study. Otherwise, the authors report no competing interests related to this study.
      (Georg Thieme Verlag KG Stuttgart · New York.)
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    • Accession Number:
      0 (Anti-Bacterial Agents)
    • Publication Date:
      Date Created: 20190404 Date Completed: 20200401 Latest Revision: 20200401
    • Publication Date:
      20240829
    • Accession Number:
      PMC6447403
    • Accession Number:
      10.1055/s-0039-1683877
    • Accession Number:
      30943571