Reduction of incorrect antibiotic dosing through a structured educational order form.

Before intervention, incorrect dosing orders for clindamycin, cefazolin, and metronidazole were 90%, 60% and 75% patient days of therapy respectively.  After implementation, nonrecommended dosing fell to under 6% of patient days. Savings amounted to $76,000 annually in drug costs.

Reference:
Avorn J, Soumerai SB, Taylor W, Wessels MR, Janousek J, and Weiner M.  Reduction of incorrect antibiotic dosing through a structured educational order form. Archives of Internal Medicine. 1988; 148:1720-1724

Setting:
621-bed, tertiary-care teaching hospital, Boston, MA, USA

Key staff:
Infectious disease physicians

Intervention:
Order form – Creation of an order form with preset dosing orders for clindamycin, cefazolin and metronidazole. Physicians still had option to choose own dosing schedule on the form.

Impact:
Before intervention, incorrect dosing orders for clindamycin, cefazolin, and metronidazole were 90%, 60% and 75% patient days of therapy respectively.  After implementation, non-recommended dosing fell to under 6% of patient days. Savings amounted to $76,000 annually in drug costs.

Tools:
Antibiotic order form