Antibiotics prescribed at discharge accounted for 93.2% of excess days of therapy in the multihospital study, highlighting “an urgent and unmet need for discharge stewardship,” the authors wrote.
While shorter antibiotic duration is safe and effective for general medicine patients admitted with pneumonia, excess treatment is common, especially at discharge, a retrospective cohort study found.
Researchers used data from 43 hospitals in the Michigan Hospital Medicine Safety Consortium to assess the rate of excess antibiotic treatment duration (excess days per 30-day period) in 6,481 adult general medicine patients (median age, 70.2 years; 51.2% women) hospitalized with community-acquired pneumonia (CAP; 73.2% of cohort) or health care–associated pneumonia (HCAP; 26.8% of cohort). Eligible patients had a discharge diagnostic code for pneumonia, symptoms and radiographs consistent with pneumonia, receipt of at least four days of antibiotic treatment, and receipt of antibiotics on hospital day one or two (to exclude hospital-acquired pneumonia). Study participants were discharged between January 2017 and April 2018.