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Impact of Automatic Orders to Discontinue Vancomycin Therapy on Vancomycin Use in an Antimicrobial Stewardship Program

Published online by Cambridge University Press:  02 January 2015

Denise M. Connor
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia
Shawn Binkley
Affiliation:
Department of Pharmacy, University of Pennsylvania School of Medicine, Philadelphia
Neil O. Fishman
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia
Leanne B. Gasink
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia
Darren Linkin
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia
Ebbing Lautenbach*
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia
*
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 825 Blockley Hall, 423 Guardian Dr., Philadelphia, PA 19104-6021 (ebbing@mail.med.upenn.edu)

Abstract

We examined the possible unintended consequences of a 72-hour automatic order to discontinue vancomycin therapy in an antimicrobial stewardship program (ASP). Of 120 patients, 11 had vancomycin therapy discontinued at 72 hours without a call to the ASP, and 7 experienced a treatment interruption of 6-36 hours. All discontinuation of therapy was considered appropriate, and the 7 treatment interruptions did not have clear clinical consequences. Only one-third of patients had ASP stickers that warned of impending discontinuation of vancomycin therapy placed appropriately in the medical record.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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Impact of Automatic Orders to Discontinue Vancomycin Therapy on Vancomycin Use in an Antimicrobial Stewardship Program
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