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Antibiotic Timeout Notification addresses resistance challenge

18 Dec 2022

Note added to EMR sidebar Dec. 20 as yellow warning

By: Jasmine Chaudhary, MD, CWS-P and Danielle Britt, MA, PharmD

Antimicrobial resistance continues to be a challenge. According to the CDC, hospital-related resistant infections and deaths increased at least 15% nationally during the first year of the Covid-19 pandemic.

Antibiotic overuse contributes to resistance. Based on recent internal data obtained from CDC’s National Healthcare Safety Network (NHSN), broad spectrum antibiotic use for community-acquired infections is very prevalent which in turn leads to increased hospital-acquired infections, mortality and cost to the patient.

We are addressing this challenge:

  • Starting Dec. 20, an automated “Antibiotic Timeout Notification” will be added to a patient’s EMR sidebar and will be only visible to providers and pharmacists. This notification is NOT a BPA and will not interfere with viewing a patient’s chart. The notification will provide an opportunity to review a patient’s antimicrobial therapy 36 to 72 hours into a regime and make appropriate changes based on emerging blood, urine and other culture results.
  • We hope that this will increase awareness for the provider regarding what antibiotics the patient is receiving and give opportunities for de-escalation, dose change or change in antibiotic route based on emerging culture data. This in turn will decrease hospital acquired infections, resistance and cost to the patient.

Below is a summary of the antimicrobial timeout notification. It appears as a yellow warning in the patient sidebar like this:


Hovering over the yellow alert displays this:



Clicking on the alert displays this:



The settings for this warning have the following nuances:

  1. If the ‘therapy reviewed and updated’ acknowledgement is selected, the warning disappears for all users for the remainder of the patient encounter.
    • Will not appear if a different antibiotic is ordered during the patient encounter after this option is selected.
  1. If the ‘awaiting culture results (defer 24 hours)’ is selected, the warning disappears for all users for 24 hours.
  2. Only appears for Physicians, Pharmacists, Physician Assistant, Nurse Practitioner, Fellow, and MD Resident.