Photo Credit: Jomkwan

For non-critically ill patients with UTIs, computerized provider order entry (CPOE) prompts that provide risk estimates for patient- and pathogen-specific multidrug-resistant organisms (MDRO) can reduce empiric extended-spectrum antibiotic use, according to a study published in JAMA. Shruti K. Gohil, MD, MPH, and colleagues examined whether CPOE prompts with specific MDRO risk estimates could reduce the use of empiric extended-spectrum antibiotics across 59 hospitals. The researchers compared the effect of a CPOE stewardship bundle versus routine stewardship on antibiotic selection during the first 3 hospital days for a 15-month intervention period and an 18-month baseline period. Participants had low estimated absolute risk for MDRO UTI. Data were included for 127,403 adults: 71,991 at baseline and 55,412 during the intervention. A 17.4% reduction in empiric extended-spectrum days of therapy was seen in the group using CPOE prompts versus routine stewardship (rate ratio, 0.83). The study team noted no significant difference between the CPOE prompt and routine groups in mean days to ICU transfer or length of stay.