Failure to Justify and Monitor Antibiotic Use According to Stewardship Policy
Penalty
Summary
The facility failed to justify the use of antibiotics for three out of four residents reviewed for antibiotic stewardship. For one resident, antibiotics were administered despite urine cultures showing no organism or growth, and the resident was unaware of the reason for the medication. Another resident received cephalexin for a urinary tract infection, but the laboratory report indicated the organism might not respond to cephalosporins, and the resident was not informed about the medication. A third resident was given cefuroxime for a urinary tract infection caused by an ESBL-producing organism, with documentation noting that such organisms may not respond to cephalosporins, yet the antibiotic was still administered. Interviews with facility staff revealed that the Infection Control Preventionist was aware of the need to be mindful of organisms but stated that prescribers did not always follow guidance. The facility's policy required review of all antibiotic orders to ensure appropriate indication, dose, and duration, but this process was not effectively implemented, as evidenced by the continued administration of antibiotics without proper justification or adherence to laboratory findings.