Don’t continue antibiotics beyond 72 hours in hospitalized patients unless patient has clear evidence of infection.
|Rationale and Comments:||Antibiotics are often started when a patient is possibly infected. After three days, laboratory and radiology information is available and antibiotics should either be deescalated to a narrow-spectrum antibiotic based on culture results or discontinued if evidence of infection is no longer present. Lessening antibiotic use decreases risk of infections with C. difficile or antibiotic-resistant bacteria.|
|References:||• Core Elements of hospital antibiotic stewardship programs from the Centers for Disease Control and Prevention [Internet]. Atlanta (GA): Centers for Disease Control and Prevention; 2015 [updated 2015 May 7; cited 2015 Jul 21]. Available from: http://www.cdc.gov/getsmart/healthcare/implementation/core-elements.html.
• Antibiotic resistance threats in the United States, 2013 [Internet]. Atlanta (GA): Centers for Disease Control and Prevention; 2013 [cited 2015 Jul 21]. Available from: http://www.cdc.gov/drugresistance/threat-report-2013/pdf/ar-threats-2013-508.pdf.
• Elligsen M, Walker SA, Pinto R, Simor A, Mubareka S, Rachlis A, Allen V, Daneman N. Audit and feedback to reduce broad-spectrum antibiotic use among intensive care unit patients: a controlled interrupted time series analysis. Infect Control Hosp Epidemiol. 2012 Apr;33(4): 354-61.