Failure to Monitor and Evaluate Antibiotic Usage per Stewardship Program
Penalty
Summary
The facility failed to monitor and evaluate antibiotic usage for five of seven residents reviewed for antibiotic use, as required by both CDC guidance and the facility's own Antibiotic Stewardship policy. Specifically, antibiotics were prescribed and administered to residents without adherence to McGeer Criteria, and in several cases, laboratory results such as urine cultures were negative or contaminated, yet antibiotics were still initiated. For example, one resident was started on Amoxicillin despite a negative culture, another was given Bactrim after a contaminated culture that was not repeated, and others received antibiotics for respiratory or urinary issues without meeting established criteria or having appropriate diagnostic testing completed. Interviews with facility staff revealed a lack of questioning or oversight regarding physician antibiotic orders, with the Infection Preventionist acknowledging that antibiotics are often started before culture results are available and that there is a need to follow McGeer Criteria and educate staff. The Medical Director admitted to not fully understanding the purpose of antibiotic stewardship, and the Administrator recognized the need to track antibiotic usage and adhere to policies. These actions and inactions resulted in the facility not effectively monitoring or evaluating antibiotic use as required.