“Your Patient Doesn't Need a Broad-Spectrum Antibiotic”

Almost half of patients who are hospitalized for pneumonia or urinary tract infections (UTIs) receive unnecessary extended-spectrum antibiotics. In two studies, researchers evaluated whether real-time identification of inpatients at low risk for multidrug-resistant organisms could limit use of extended-spectrum agents. In both trials, researchers randomized 59 community-based U.S. hospitals to use routine antibiotic stewardship (i.e., education, coaching, and feedback) or routine stewardship plus real-time computerized order-entry (CPOE) prompts (recommending standard-spectrum antibiotics in patients with low estimated risk for multidrug-resistant organisms) in non–critically ill adults (mean age, 68) with pneumonia or UTIs. An 18-month bas…