Antimicrobial Consumption Data From Pharmacy and Nursing Records: How Good Are They?

2005 ◽  
Vol 26 (4) ◽  
pp. 395-400 ◽  
Author(s):  
Gail S. Itokazu ◽  
Robert C. Glowacki ◽  
David N. Schwartz ◽  
Mary F. Wisniewski ◽  
Robert J. Rydman ◽  
...  
Keyword(s):  
Medication Administration ◽  
Cross Sectional Study ◽  
Antimicrobial Use ◽  
Antimicrobial Consumption ◽  
Sectional Study ◽  
Surgical Intensive Care ◽  
Cross Sectional ◽  
Dose Administration ◽  
Consumption Data ◽  
Pharmacy Data

AbstractObjective:To determine whether randomly selected intravenous (IV) antimicrobial doses dispensed from an inpatient pharmacy were administered.Design:This was a prospective, cross-sectional study in which dose administration was confirmed by direct observation and by assessment of the medication administration record (MAR). A retrospective analysis of the return rate of unused IV antimicrobial doses was performed subsequently.Setting:Medical and surgical intensive care units (ICUs) and non-ICUs of a 550-bed urban public teaching hospital.Participants:Hospitalized patients with an order in the pharmacy database for an IV antimicrobial during 9 non-consecutive weekdays in June 1999.Results:Of 397 doses, 221 (55.7%) assessed by bedside observation and 238 (59.9%) assessed by MAR review were classified as administered; 139 doses (35.0%) were dispensed but changes in the drug order or the patient's status prevented their administration. In the subsequent assessment, of 745 IV antimicrobial doses dispensed during 24 hours, 322 (43.2%) were returned to the pharmacy unused; 423 (56.8%) of the doses—consistent with our prior observations—were presumably administered.Conclusions:Because computerized pharmacy data may overestimate actual antimicrobial consumption, such data should be validated when used in studies of hospital antimicrobial use. Dispense-return analysis offers a simple validation method.

scholarly journals Prevalence of intravenous medication administration errors: a cross-sectional study

2017 ◽  
Vol Volume 6 ◽  
pp. 47-51 ◽  
Author(s):  
Tezeta Fekadu ◽  
Mebrahtu Teweldemedhin ◽  
Eyerusalem Esrael ◽  
Solomon Weldegebreal Asgedom
Keyword(s):  
Medication Administration ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medication Administration Errors ◽  
Intravenous Medication

scholarly journals 232. Impact of Weekend Initiation of Vancomycin or Piperacillin/Tazobactam on Days of Therapy Received upon Hospital Admission

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S117-S117
Author(s):  
Jessina C McGregor ◽  
Caitlin M McCracken ◽  
Samuel F Hohmann ◽  
Amy L Pakyz
Keyword(s):  
Cross Sectional Study ◽  
Large Sample Size ◽  
Sectional Study ◽  
Clinical Database ◽  
Cross Sectional ◽  
Wilcoxon Rank Sum Test ◽  
Days Of Therapy ◽  
Significant Difference ◽  
Pharmacy Data ◽  
Hospital Staffing

Abstract Background Antibiotic therapy for inpatients with suspected infections is typically empirically initiated and therapy narrowed or altered when additional diagnostic evidence becomes available. For patients whose therapy is initiated on a weekend, differences in hospital staffing may impact the timing of therapy changes. We aimed to compare the duration of therapy of vancomycin and piperacillin-tazobactam between those who had therapy initiated on a weekday versus a weekend day. Methods We performed a cross-sectional study among U.S. hospitals that contributed pharmacy data for inpatients to the Vizient clinical database in 2016. We identified vancomycin and piperacillin-tazobactam courses initiated within the first 48 hours of admission; courses were categorized as weekend initiation (Friday, Saturday, Sunday) versus weekday initiation. The median days of therapy were compared between weekend and weekday initiation using the Wilcoxon rank-sum test. Results Among the 145 hospitals representing approximately 3.7 million patient encounters there were 401,101 encounters with vancomycin and 221,751 with piperacillin/tazobactam initiated within the first 48 hours of admission. Of these courses, 33% of vancomycin and 40% of piperacillin/tazobactam were initiated on a weekend day. The median (IQR) days of therapy for vancomycin initiated on a weekend was 2 days (1–4 days) compared to 2 days (1–3 days) when initiated on a weekday (p< .01). The median (IQR) days of therapy for piperacillin/tazobactam was 3 days (2–5 days) for courses initiated on either a weekend or weekday (p< .01). Conclusion We observed a statistically significant difference in the days of therapy received by patient encounters with vancomycin or piperacillin/tazobactam initiated on weekdays versus weekends. However, because of the large sample size in this study, we had power to identify small differences as statistically significant. Still, for vancomycin the 75th percentile received at least one additional day of therapy when initiated on a weekend versus a weekday. Further exploration is needed to identify if weekend initiation is associated with extended durations of therapy in specific sub-populations of patients. Disclosures All Authors: No reported disclosures

scholarly journals Cross-sectional study of antimicrobial use and treatment decision for preweaning Canadian dairy calves

2021 ◽  
Author(s):  
Tamaki Uyama ◽  
David F. Kelton ◽  
Emma I. Morrison ◽  
Ellen de Jong ◽  
Kayley D. McCubbin ◽  
...  
Keyword(s):  
Treatment Decision ◽  
Cross Sectional Study ◽  
Dairy Calves ◽  
Antimicrobial Use ◽  
Sectional Study ◽  
Cross Sectional

Nationwide Cross-Sectional Study of Antimicrobial Stewardship and Antifungal Stewardship Programs in Inpatient Settings in Japan

2021 ◽  
Author(s):  
Yuki Moriyama ◽  
Masahiro Ishikane ◽  
Yoshiki Kusama ◽  
Nobuaki Matsunaga ◽  
Taichi Tajima ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Cross Sectional Study ◽  
Antimicrobial Use ◽  
Sectional Study ◽  
Antifungal Stewardship ◽  
Cross Sectional ◽  
Hospital Epidemiology ◽  
Web Based ◽  
Inpatient Settings

Abstract Background To prevent antimicrobial resistance, both antimicrobial stewardship (AMS) and antifungal stewardship (AFS) in inpatient settings are needed in small/middle-sized hospitals as well as large hospitals. Methods We conducted the web-based, self-administered, nationwide cross-sectional study regarding AMS and AFS in inpatient settings in Japan, targeting hospitals that participated in a hospital epidemiology workshop conducted in July 2018. The questionnaire was composed of intervention protocols for use of broad-spectrum antimicrobials and antifungals within 7 or 28 d of beginning usage. These broad-spectrum antimicrobial and antifungal protocols were compared between large (≥ 501beds) and small/middle-sized (≤ 500 beds) hospitals. Results Of 240 hospitals surveyed, 39 (16%; 18 large and 21 small/middle-sized) responded. The number of hospitals that intervened in the use of broad-spectrum antimicrobials within 7 and 28 d were 17 (44%) and 34 (87%), respectively; those that intervened for antifungals were 3 (8%) and 10 (26%), respectively. Interventions for use of broad-spectrum antimicrobials within 7 d were significantly more frequent in small/middle-sized hospitals compared to large hospitals [13 (61. 9%) vs. 4 (22. 2%), odds ratio = 5.7, 95% confidence interval = 1.4–23.3, p = 0.023]. Conclusions Small/middle-sized hospitals had more frequent interventions within 7 d of broad-spectrum antimicrobial use than large hospitals. More effort to improve AFS is needed among all hospitals.

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