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Updated: Jul 6, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Suboptimal antimicrobial discharge prescriptions at a tertiary referral children's hospital

Yi Wolf Zhang1, Sruti Paturi2, Lauren M Puckett3

  • 1Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA, USA.

Antimicrobial Stewardship & Healthcare Epidemiology : ASHE
|December 29, 2023
PubMed

Insights

Nearly 20% of pediatric discharge antimicrobial prescriptions were suboptimal, often due to incorrect duration or dose. Improving antimicrobial stewardship during care transitions is crucial.

Area of Science:

  • Pediatric Pharmacology
  • Antimicrobial Stewardship
  • Health Services Research

Background:

  • Suboptimal antimicrobial prescribing at hospital discharge can lead to treatment failure and resistance.
  • Effective antimicrobial stewardship programs are essential for optimizing antibiotic use.

Purpose of the Study:

  • To determine the rate and factors associated with suboptimal discharge antimicrobial prescribing in a pediatric hospital.
  • To identify areas for improvement in antimicrobial stewardship during care transitions.

Main Methods:

  • Retrospective cohort study of enteral antimicrobial discharge prescriptions.
  • Evaluation of prescriptions by an antimicrobial stewardship pharmacist based on choice, dose, duration, frequency, and formulation.
  • Analysis of prescribing data from January 2021 to December 2021.

Main Results:

  • 19.7% of 2,593 discharge antimicrobial prescriptions were suboptimal.
  • Incorrect duration (72.2%) and dose (31.0%) were the most common issues.
  • Amoxicillin-clavulanate, clindamycin, and cephalexin had high rates of suboptimal prescribing.

Conclusions:

  • Suboptimal discharge antimicrobial prescribing is prevalent in pediatric care.
  • Targeted interventions are needed to address specific prescribing errors and drug-related issues.
  • Antimicrobial stewardship programs can play a key role in optimizing antibiotic use during hospital discharge.
Abstract

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