Related Experiment Video
Updated: May 7, 2025
Preparation of a Blood Culture Pellet for Rapid Bacterial Identification and Antibiotic Susceptibility Testing
Published on: October 15, 2014
Impact of 24-hour pharmacy call response on time to antibiotics in open fractures
Bacil Kadi1, Melanie Smith Condeni2, Taylor Morrisette3
1Department of Pharmacy, The Ohio State Wexner Medical Center, Columbus, OH, USA.
Purpose:
Open fractures are associated with significant morbidity after trauma, which is driven, in part, by infection. Current literature and guidelines recommend that this patient population receive antimicrobial prophylaxis within 1 hour of emergency department (ED) arrival to minimize the risk of infection. The primary aim of this study was to investigate whether the addition of a trauma response to a pharmacy resident on-call program resulted in antibiotic administration within 1 hour of presentation to a higher proportion of patients with open fractures.
Methods:
This was a retrospective, observational, quasi-experimental analysis that was conducted at an academic medical facility with a level 1 trauma center for patients presenting to the ED from January 2019 to December 2020 (preimplementation period) and from January 2021 to December 2022 (postimplementation period). Patients were included if they were 18 years of age or older and presented to the ED with an open fracture(s). Patients with independent fractures of fingers and those who died in route to or in the ED were excluded. The primary outcome was the proportion of patients with antibiotic administration within 1 hour of ED presentation for patients with open extremity fractures.
Results:
A total of 292 patients met the eligibility criteria (49% in the preimplementation group and 51% in the postimplementation group). Patients were predominantly male (61% vs 58%), with an overall median age of 46 years. Following implementation of the on-call pharmacy resident trauma response, a significantly higher proportion of patients received antibiotics within 1 hour of presentation (70% vs 83%; P = 0.019). The median (interquartile range) time to antimicrobial administration was also significantly shorter in the postimplementation group (31 [16-68] minutes vs 19 [10-50] minutes; P = 0.005).
Conclusion:
The addition of a 24-hour on-call pharmacy resident response in the ED was associated with improved antibiotic administration within 1 hour of presentation in patients with open fractures.
Related Concept Videos
01:15Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:14SBAR II: Application of SBAR
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
01:19One-Compartment Open Model for IV Bolus Administration: General Considerations
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant,...