Preoperative Antibiotic Orders: Protocol-Initiated Pharmacist Order Entry.

Area of Science:

• Infectious Diseases
• Pharmacology
• Surgical Care

Background:

• Methicillin-resistant Staphylococcus aureus (MRSA) colonization poses a risk for surgical site infections.
• Optimizing preoperative antibiotic selection is crucial for preventing MRSA-related complications.

Purpose of the Study:

• To assess the impact of a pharmacist order entry protocol on preoperative antibiotic selection for MRSA-colonized patients.
• To evaluate changes in antibiotic dose accuracy and timing post-protocol implementation.

Main Methods:

• Retrospective chart review of orthopedic surgery procedures.
• Inclusion of patients with documented MRSA colonization.
• Comparison of antibiotic orders before and after protocol implementation.

Main Results:

• Appropriate antibiotic selection increased from 63% pre-protocol to 81% post-protocol (p=0.1155).
• Antibiotic dose accuracy was high in both groups (96% pre, 97% post).
• Correct timing of administration decreased post-protocol (82% pre vs. 68% post, p=0.42).

Conclusions:

• Pharmacist-initiated protocols can enhance appropriate antibiotic selection for MRSA-colonized surgical patients.
• Antibiotic dosing remained consistent, but timing was affected by concurrent antibiotic use.
• Further research is needed to link improved selection to reduced postoperative MRSA infections.