The use of antibiotics requires careful balance between achieving therapeutic cure and preventing antibiotic-related adverse effects. The risk of antibiotic-related harm increases with each day of continued antibiotic therapy. Therefore, defining the total antibiotic duration is important.

The Antibiotic Therapeutic Guidelines was revised in April 2019 and for many common infections the treatment duration has been shortened to align practice with new evidence.

Western Health Recommended EMR Best Practice

1. Input Stop Date/Time for inpatient antibiotics
2. When performing a discharge reconciliation, hover over existing inpatient orders to view stop date/time and manually transcribe this over in the reconciliation orders column so that this information will appear on the patient’s script once it is generated on completion of the discharge reconciliation

Input a Stop Date/Time

When the antibiotic treatment duration has been defined, the ‘Stop Date/Time’ should be recorded in the EMR antibiotic Order. The Stop Date/Time can either be entered manually in the ‘Stop Date/Time’ field or by completing the ‘Duration from now to end point’ and ‘Duration unit’ fields, which will automatically calculate the Stop Date/Time, as shown below.

Discharge Medication Reconciliation

However when the same patient is discharged from the hospital prior to the ‘stop date/time’ specified, during the process of discharge medication reconciliation, the remaining duration of the course of the drug is not automatically carried forward when the ‘Continue After Discharge’   or ‘Create New Rx’   is selected.

In order to know when the initial inpatient order is scheduled to stop, actively hover your mouse over the initial inpatient order to see the stop date and time. Then manually key in the stop date and time into the associated order for reconciliation.