Purpose: A template for reviewing use patterns, including graphic comparison over time.
Source: S. Brown & B. Ostrowsky, Montefiore Medical Center.
Instructions: This template may be tailored for possible use at your facility; review and adapt as appropriate.
Medication Use Evaluation
Unit/Area: XXX Medical Center (XXX Campus)
Submitted by: Antibiotic Stewardship Program
Title: Oral Azithromycin Utilization Evaluation
Date: XXX
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Indicators: (1) Usage and mean duration of oral azithromycin before and after unrestriction; and (2) whether there is a decrease in quinolone use before and after unrestricting azithromycin.
Plan
Disciplines Involved: Antibiotic Stewardship Program
Monitoring Period: XXX – XXX
Sample Size: XXX patients at Campus and XXX patients at Campus according to SYBASE query listing.
Methodology: Retrospective reviews of antibiotic usage were conducted in patients who received oral azithromycin from XXX to XXX. The total numbers of patients on oral azithromycin, ciprofloxacin, moxifloxacin, and various other antibiotic combinations (i.e., azithromycin plus ceftriaxone, piperacillin/tazobactam, ciprofloxacin, or moxifloxacin) were calculated. Analyses were conducted to determine the usage and mean duration of oral azithromycin before and after unrestriction.
Do
Reports were generated using the SYBASE query listing all patients who received oral azithromycin, ciprofloxacin, moxifloxacin, piperacillin/tazobactam, and ceftriaxone between XX and XX.
Check
- A total of XXX (nonexclusive) patients were included in this review (Table 1).
Table 1
| Month | Month | Month | |
|---|---|---|---|
| Campus | |||
| Mean duration of azithromycin (range), days of therapy | X (Y-Z) | X (Y-Z) | X (Y-Z) |
| Antibiotics | Number of Patients | ||
| Azithromycin PO | XX | XX | XX |
| Moxifloxacin PO | XX | XX | XX |
| Ciprofloxacin PO | XX | XX | XX |
| Campus | |||
| Mean duration of azithromycin (range), days of therapy | X (1-X) | X (1-X) | X (1-X) |
| Antibiotics | Number of Patients | ||
| Azithromycin PO | XX | XX | XX |
| Moxifloxacin PO | XX | XX | XX |
| Ciprofloxacin PO | XX | XX | XX |
Table 2. Azithromycin PO and Ceftriaxone
| Month | Month | Month | |
|---|---|---|---|
| Campus | |||
| Number of patients | XX | XX | XX |
| Duration of azithromycin (range), days of therapy | X (1-X) | X (1-X) | X (1-X) |
| Campus | |||
| Number of patients | XX | XX | XX |
| Duration of azithromycin (range), days of therapy | X (1-X) | X (1-X) | X (1-X) |
Table 3. Number of Patients on Azithromycin PO and Moxifloxacin
| Month | Month | Month | |
|---|---|---|---|
| Moses | XX | XX | XX |
| Weiler | XX | XX | XX |
Table 4. Number of Patients on Azithromycin PO and Ciprofloxacin
| Month | Month | Month | |
|---|---|---|---|
| Moses | XX | XX | XX |
| Weiler | XX | XX | XX |
Table 5. Number of Patients on Azithromycin PO and Piperacillin/ tazobactam
| Month | Month | Month | |
|---|---|---|---|
| Moses | XX | XX | XX |
| Weiler | XX | XX | XX |
Figure 1. Comparison of Oral Azithromycin and Quinolone Usage at Campus, Before Unrestriction
Figure 2. Comparison of Oral Azithromycin and Quinolone Usage at Campus, After Unrestriction
Act
- There was a trend of XX oral azithromycin usage comparing XX to XX after unrestriction.
- There was a trend of decreasing oral moxifloxacin usage comparing XX to XX; however, it might be an artifact of seasonal change. Comparing XX to XX, the total number of patients on oral moxifloxacin did not change significantly.
- The antibiotic stewardship program will continue to monitor oral azithromycin usage via pharmacist/house staff education on duration of therapy and prevent double atypical coverage for asthma, chronic obstructive pulmonary disease, or community-acquired pneumonia.
