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Related Experiment Videos

An antibiotic order form intervention does not improve or reduce vancomycin use.

Maureen K Bolon1, Alana D Arnold, Henry A Feldman

  • 1Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. m-bolon@northwestern.edu

The Pediatric Infectious Disease Journal
|December 24, 2005
PubMed
Summary

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A paper-based antibiotic order form (AOF) did not improve antibiotic stewardship. Inappropriate vancomycin use increased after AOF implementation, indicating the system was ineffective.

Area of Science:

  • Infectious Diseases
  • Hospital Pharmacy
  • Antibiotic Stewardship

Background:

  • Antibiotic stewardship programs aim to optimize antibiotic use and improve patient outcomes.
  • Paper-based antibiotic order forms (AOFs) have been proposed as a tool to enhance stewardship.
  • The effectiveness of AOFs in controlling vancomycin prescribing requires further investigation.

Purpose of the Study:

  • To evaluate the effectiveness of a paper-based antibiotic order form (AOF) as an antibiotic stewardship measure.
  • To determine the impact of an AOF on the appropriateness and utilization of vancomycin prescribing.
  • To assess changes in vancomycin use density following AOF implementation.

Main Methods:

  • Retrospective review of vancomycin courses before and after AOF introduction at a pediatric tertiary care hospital.

Related Experiment Videos

  • Evaluation of AOF compliance rates and their correlation with vancomycin prescribing appropriateness.
  • Univariate and multivariable analyses to assess the impact of the AOF on vancomycin use, adjusting for confounding factors.

    • Main Results:

    • Poor initial compliance with the AOF (<50%), with improvement to 70-80% in an extended period.
    • Increased rates of inappropriate vancomycin use post-AOF implementation (35% before, 39% post-AOF, 51% with improved compliance).
    • Adjusted analysis revealed significantly more inappropriate vancomycin utilization after AOF introduction, with increased vancomycin doses per 1000 patient days.

    Conclusions:

    • The paper-based antibiotic order form (AOF) intervention was ineffective in improving antibiotic stewardship.
    • Inappropriate vancomycin use and overall vancomycin utilization increased following AOF implementation.
    • The AOF did not achieve its intended effect of reducing and optimizing vancomycin prescribing.