title: Impact of automatic orders to discontinue vancomycin therapy on vancomycin use in an antimicrobial stewardship program.
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.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6021, USA.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Connor
authors.forename: Shawn
authors.initials: S
authors.lastname: Binkley
authors.forename: Neil O
authors.initials: NO
authors.lastname: Fishman
authors.forename: Leanne B
authors.initials: LB
authors.lastname: Gasink
authors.forename: Darren
authors.initials: D
authors.lastname: Linkin
authors.forename: Ebbing
authors.initials: E
authors.lastname: Lautenbach
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001331:Automation; D019091:Critical Pathways; D004334:Drug Administration Schedule; D005572:Formularies, Hospital as Topic; D006785:Hospitals, University; D006801:Humans; D008485:Medical Audit; D008499:Medical Records / Q000706:statistics & numerical data; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin