Unnecessary Prolonged Antibiotic Administration
Penalty
Summary
A deficiency was identified when a resident, who had resided in the facility for over a year, was prescribed and administered levofloxacin (Levaquin) for 10 days to treat a cough with phlegm, which was initially assessed as bronchitis and possible pneumonia. The physician's progress note indicated that the antibiotic was to be started for 7 days, pending chest x-ray results to determine if a change in antibiotics was necessary. The chest x-ray, performed the same day, showed no active cardiopulmonary disease. Despite this, the resident received the antibiotic for 10 days, as documented in the Medication Administration Record. During an interview, the physician clarified that the antibiotic should have been prescribed for only 7 days and attributed the 10-day administration to a misunderstanding. The facility's antibiotic stewardship policies, last revised in December 2016, were reviewed in relation to this incident. The failure to ensure the resident was free from unnecessary antibiotics, specifically the administration of an antibiotic for longer than intended, constituted the deficiency.