Improved empiric antibiotic prescribing for common infectious disease diagnoses using order sets with built-in clinical decision support in the emergency department

To the Editor—The Centers for Disease Control and Prevention estimated that in 2018, emergency departments (EDs) generated 12.7 million antibiotic prescriptions. ¹ Up to 50% of these prescriptions may have been inappropriate with respect to antibiotic use or selection, dosing, and duration, based on outpatient prescribing estimates. ² Improving prescribing is imperative, but historically, EDs are underrepresented in antibiotic stewardship studies. ⁴ EDs may benefit from implementation of the recommended components of an antimicrobial stewardship program, including decision-making tools based on facility-specific practice guidelines. ³ For example, antibiotic order sets within an electronic medical record (EMR) have been shown to improve adherence to evidence-based prescribing for single diagnoses, ^5,6 although the use of multiple order sets for a variety of diagnoses has not been well studied. We implemented EMR order sets for common infectious diagnoses in the ED, compared the prescribing practices of providers who utilized them to those who did not, and surveyed providers for barriers to use.
 

Citation: Seitz, R., Wiley, Z., Francois, C., Moran, T., Rupp, J., & Sexton, M. (2021). Improved empiric antibiotic prescribing for common infectious disease diagnoses using order sets with built-in clinical decision support in the emergency department. Infection Control & Hospital Epidemiology, 1-2. doi:10.1017/ice.2021.73

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