The effects of missed doses of antibiotics on hospitalized patient outcomes

Chandni N. Patel, Michael D Swartz, Jeffrey S. Tomasek, Laura E. Vincent, Wallace E. Hallum, John B Holcomb

Research output: Contribution to journalArticle

Abstract

Background: Missing doses of antibiotics in hospitalized patients is a well-described but inadequately recognized issue. We hypothesized that missing doses of antibiotics decreases quality of care. Methods: Retrospective study on patients admitted to the Shock Trauma ICU from February to June 2015. Patients prescribed a multidose course of antibiotics were evaluated. A missed antibiotic dose was one ordered but never given (a completely missed dose) or a dose that was not given within an hour before or after the planned time (an off-schedule missed dose). Patient outcomes included a positive culture, ventilator, ICU and hospital length of stay (LOS), and mortality. Multiple statistical methods were used as appropriate; significance was set as P < 0.05. Results: For the 5-mo study period, 280 patients were admitted and 200 met inclusion criteria. Eight percent of patients (16/200) did not miss any antibiotic doses, 39% (77/200) had only off-schedule doses, 2% (4/200) had only completely missed doses, and 51% (103/200) had both off-schedule and completely missed doses. For the 200 patients, 8167 doses were ordered and 2096 (26%) were missed. Adjusting for age, gender, BMI, injury severity score, and doses of antibiotics showed that those who miss doses off-schedule had longer LOS than those who do not miss doses of antibiotics. There was a significant nonlinear relationship between LOS and frequency of early (P-value = 0.02) and late (P-value = 0.01) doses. Conclusions: To reduce length of hospital stay and optimize quality, methods to improve compliance with antibiotic dosing schedules should be investigated.

LanguageEnglish
Pages276-283
Number of pages8
JournalJournal of Surgical Research
Volume233
DOIs
StatePublished - Jan 1 2019

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Anti-Bacterial Agents
Length of Stay
Appointments and Schedules
Injury Severity Score
Quality of Health Care
Mechanical Ventilators
Hospital Mortality
Shock
Retrospective Studies
Wounds and Injuries

Keywords

  • Complications
  • Missed antibiotics
  • Outcome
  • Quality

ASJC Scopus subject areas

  • Surgery

Cite this

Patel, C. N., Swartz, M. D., Tomasek, J. S., Vincent, L. E., Hallum, W. E., & Holcomb, J. B. (2019). The effects of missed doses of antibiotics on hospitalized patient outcomes. Journal of Surgical Research, 233, 276-283. https://doi.org/10.1016/j.jss.2018.08.015

The effects of missed doses of antibiotics on hospitalized patient outcomes. / Patel, Chandni N.; Swartz, Michael D; Tomasek, Jeffrey S.; Vincent, Laura E.; Hallum, Wallace E.; Holcomb, John B.

In: Journal of Surgical Research, Vol. 233, 01.01.2019, p. 276-283.

Research output: Contribution to journalArticle

Patel, CN, Swartz, MD, Tomasek, JS, Vincent, LE, Hallum, WE & Holcomb, JB 2019, 'The effects of missed doses of antibiotics on hospitalized patient outcomes' Journal of Surgical Research, vol. 233, pp. 276-283. https://doi.org/10.1016/j.jss.2018.08.015
Patel CN, Swartz MD, Tomasek JS, Vincent LE, Hallum WE, Holcomb JB. The effects of missed doses of antibiotics on hospitalized patient outcomes. Journal of Surgical Research. 2019 Jan 1;233:276-283. https://doi.org/10.1016/j.jss.2018.08.015
Patel, Chandni N. ; Swartz, Michael D ; Tomasek, Jeffrey S. ; Vincent, Laura E. ; Hallum, Wallace E. ; Holcomb, John B. / The effects of missed doses of antibiotics on hospitalized patient outcomes. In: Journal of Surgical Research. 2019 ; Vol. 233. pp. 276-283.
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