Appropriateness of Antibiotic Prescribing in Patients Discharged From a Community Hospital Emergency Department

IMPORTANCE: Every year, thousands of emergency department (ED) visits result in patients being discharged with oral antibiotic prescriptions. Published studies that assess the appropriateness these regimens are limited. PURPOSE: The purpose this study was to examine prescriptions written for from a community hospital’s ED. ENDPOINTS: primary objective determine overall percent appropriate Secondary objectives included following: identify reasons inappropriateness categorized by selection, dose, duration, and allergies; most common antibiotics prescribed inappropriately as well disease states led inappropriate prescribing antibiotics; analyze trends based on provider type time day prescription written. STUDY DESIGN AND METHODS: Patients eligible inclusion were adults age 18 older who presented ED during four chosen weeks 2019 antibiotics. Extracted electronic health record data reviewed discharge diagnosis each patient meets criteria. Pertinent information gathered patients’ medical records along validated antimicrobial assessment tool utilized level regimens. RESULTS: A total 76% appropriate, 16% inappropriate, remaining 8% not assessable. Duration reason regimen be optimal. frequently cephalexin (but it is noted almost half study), clindamycin, azithromycin. Infections treated skin soft tissue infections, dental sinusitis. Overall, residents highest regimens, had third shift (11 p.m. 7 a.m.). CONCLUSION RELEVANCE: Almost all nonoptimal an excessive duration. Targeted local education efforts future clinical decision support can facilitate ED, ultimately improving stewardship within community.