Failure to Identify and Report Long-Term Prophylactic Antibiotic Use
Penalty
Summary
The facility failed to ensure that the Consultant Pharmacist (CP) identified and reported the long-term use of prophylactic antibiotics for a resident with multiple chronic conditions, including chronic kidney disease, anxiety disorder, hypertension, dementia, and anemia. The resident's medical record showed ongoing administration of Nitrofurantoin for urinary tract infection (UTI) prophylaxis, with physician orders repeatedly renewed without a documented rationale or review of the continued need for the medication. The care plan did not include a history of UTIs or the use of prophylactic antibiotics, and there was no documentation in the physician's progress notes justifying the ongoing use of Nitrofurantoin. Monthly pharmacy drug regimen reviews failed to mention the resident's prolonged antibiotic use, and administrative staff were unable to provide documentation of a monthly antibiotic log review for the resident. The CP reportedly reviewed antibiotic use only every six months, contrary to the facility's policy and regulatory requirements for monthly drug regimen reviews. This lack of appropriate review and reporting placed the resident at risk for inappropriate medication use.