In a large study of hospitalized pneumonia patients, two-thirds were prescribed overlong courses of antibiotics, and most of those prescriptions were written at discharge. Eldercare clinicians have an opportunity to correct this problem at intake, researcher Valerie Vaughn, M.D., M.Sc., told McKnight’s.
The study mined data from 6,500 patients at 43 Michigan hospitals, including phone conversations within one month of discharge. Every day a patient was prescribed antibiotics beyond the recommended minimum, the higher their risk of complications from the drugs. Resulting challenges included upset stomachs and yeast infections, said Vaughn, a practicing hospitalist who specializes in healthcare-associated infections.
“Reviewing antibiotics when patients arrive is key,” Vaughn told McKnight’s. Most patients who are discharged to rehab need between three and five days of therapy depending on their pneumonia diagnosis, and antibiotics can often be stopped between one and three days of their original hospital discharge, she suggests.
Vaughn and colleagues also found that hospital discharge summaries often lacked adequate antibiotic plans. Only about a third of patients had the total duration documented.
“Creating a system to ensure that this information is handed off between the hospital and nursing home is important,” Vaughn proposed. “Many systems are working to standardize handoffs and antibiotics should be included in this. In our study, patients with documentation also had more appropriate therapy. So it’s a win-win.”
Read the study