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Total duration of antimicrobial therapy resulting from inpatient hospitalization.

Abstract：

OBJECTIVE:To assess the feasibility of electronic data capture of postdischarge durations and evaluate total durations of antimicrobial exposure related to inpatient hospital stays. DESIGN:Multicenter, retrospective cohort study. SETTING:Two community hospitals and 1 academic medical center. PATIENTS:Hospitalized patients who received ≥1 dose of a systemic antimicrobial agent. METHODS:We collected and reviewed electronic data on inpatient and discharge antimicrobial prescribing from April to September 2016 in 3 pilot hospitals. Inpatient antimicrobial use was obtained from electronic medication administration records. Postdischarge antimicrobial use was calculated from electronic discharge prescriptions. We completed a manual validation to evaluate the ability of electronic prescriptions to capture intended postdischarge antibiotics. Inpatient, postdischarge, and total lengths of therapy (LOT) per admission were calculated to assess durations of antimicrobial therapy attributed to hospitalization. RESULTS:A total of 45,693 inpatient admissions were evaluated. Antimicrobials were given during 23,447 admissions (51%), and electronic discharge prescriptions were captured in 7,442 admissions (16%). Manual validation revealed incomplete data capture in scenarios in which prescribers avoided the electronic system. The postdischarge LOT among admissions with discharge antimicrobials was median 8 days (range, 1-360) with peaks at 5, 7, 10, and 14 days. Postdischarge days accounted for 38% of antimicrobial exposure days. CONCLUSION:Discharge antimicrobial therapy accounted for a large portion of antimicrobial exposure related to inpatient hospital stays. Discharge prescription data can feasibly be captured through electronic prescribing records and may aid in designing stewardship interventions at transitions of care.

journal_name

Infect Control Hosp Epidemiol

journal_title

Infection control and hospital epidemiology

authors

Dyer AP,Dodds Ashley E,Anderson DJ,Sarubbi C,Wrenn R,Hicks LA,Srinivasan A,Moehring RW

doi

10.1017/ice.2019.118

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

847-854

issue

eissn

0899-823X

issn

1559-6834

pii

S0899823X19001181

journal_volume

pub_type

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Total duration of antimicrobial therapy resulting from inpatient hospitalization.