Failure to Ensure Drug Regimen Free from Unnecessary Antibiotics
Penalty
Summary
The facility failed to ensure that a resident’s drug regimen was free from unnecessary antibiotics. A review of the clinical record for a resident admitted with diagnoses including atrial fibrillation and generalized weakness showed that the resident complained of penile discomfort and slightly cloudy urine on one occasion. Two days later, the resident had no urinary complaints and urine was clear and yellow. Despite the absence of consistent clinical signs or symptoms that met McGeer or Loeb criteria for infection, a physician ordered ceftriaxone sodium to treat a urinary tract infection, and the resident received one dose before laboratory results were available. Further review of the laboratory report revealed that the urine culture grew Klebsiella pneumoniae, and the prescribed antibiotic, ceftriaxone, was resistant to this bacterium. The facility’s documentation did not show that the required criteria for initiating antibiotic therapy were met, nor was there justification for the antibiotic order. During an interview, the DON confirmed that no additional documentation or justification could be provided to support the clinical decision to start antibiotic therapy.