Failure to Ensure Appropriate Antibiotic Prescribing and Administration
Penalty
Summary
The facility failed to ensure that antibiotics were appropriately prescribed and administered with the correct indication, dose, and duration for a resident. The resident, who had multiple diagnoses including chronic obstructive pulmonary disease, anxiety, type II diabetes, atrial fibrillation, and peripheral vascular disease, was admitted with a hospital discharge order for Macrobid 100 mg. The facility's physician order specified Macrobid 100 mg to be given twice daily every ten days for urinary tract infection prophylaxis. Review of the Medication Administration Record showed that this regimen was followed from November 2024 through June 2025. Interviews with clinical staff revealed discrepancies and confusion regarding the intended dosing schedule. The Certified Nurse Practitioner stated he would not have written such an order, and pharmacists noted the order did not match standard therapeutic regimens or FDA-approved dosages for UTI prophylaxis. The pharmacists also indicated that the order should have been clarified, but no such recommendation was made during monthly pharmacy reviews. The facility's policy required staff to compare the MAR to the medication and consult drug references if unfamiliar, but this was not followed, resulting in the continued administration of an inappropriate antibiotic regimen.