1502
Figure. 1. Vancomycin PK Workflow
critical patient information or lack of in-depth knowledge of the patient’s clinical condition. Strategies for antibiotic time-out are centered on prompting
prescribers to assess antibiotic needs or automatically stopping antibiotics to trigger review prior to renewal.7,8 Prior studies have demonstrated that use of electronic checklists integrated into the EMR in combination with face-to-face conversations with pro- viders are effective in prompting antibiotic review and reducing antibiotic utilization.5,6 Although there are reports of the suc- cessful use of automatic vancomycin stop orders in reducing inappropriate use, one concern frequently raised by clinicians is potential interruptions in therapy in cases where continuation is desired.8,9 SCAN differs from an automatic stop order because the medication is not discontinued rather, a discussion regarding vancomycin use is initiated between the pharmacist and provider.
Hospitals with existing PK consult services could integrate a
process similar to SCAN into their workflow to optimize vanco- mycin utilization. SCAN serves as a blueprint for an effective “antibiotic time-out” process particularly in settings with limited antimicrobial stewardship resources.
Acknowledgments. Financial support. No financial support was provided relevant to this article.
Conflicts of interest. Dr. Borgert reports serving on advisory board for Theravance Pharmaceuticals. Dr. Klinker reports personal fees from Melinta Therapeutics, personal fees from Nabriva Therapeutics, and personal fees from Achaogen, all outside the submitted work. All other authors report no conflicts of interest relevant to this article.
References
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https://www.cdc.gov/ antibiotic-use/healthcare/. Updated February 2018. Accessed June 25, 2018.
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https://amr-review.org/sites/default/ files/160518_Final%20paper_with%20cover.pdf. Published 2016. Accessed June 25, 2018.
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