Antimicrobial Time Out: Novel Approach to Expand Antimicrobial Stewardship in a Large, Tertiary Medical Center

Vakil, Niyati; Hirai-Yang, Angela; Gaut, Paula; Tran, Hai; Stanford, William; Sax, Harry C.; Grein, Jonathan; Shane, Rita; Stettin, Hanina; Woolsey, Tyler; Censullo, Andrea; Ma, Andrew; Murthy, Rekha

doi:10.1093/ofid/ofv133.971

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“…[4][5][6][7] Pharmacist prompted ATO has also been described, including pharmacist-driven programs occurring during multidisciplinary rounds. [8][9][10] In early 2017, the Ohio State University Wexner Medical Center (OSUWMC) multidisciplinary ASP implemented an ATO program using a passive approach by encouraging providers to use a templated progress note within the electronic health record to document actions taken as a result of ATO. The ATO note proposed documentation of the following components: antimicrobial indication, drug, dose, and duration.…”

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confidence: 99%

Clinical Impact of an Antibiotic Time Out Initiative at an Academic Medical Center

et al. 2020

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Background: Various strategies aimed at limiting inappropriate antimicrobial use including antibiotic time out (ATO) have been proposed to combat the development of antimicrobial resistance, yet there are limited studies that have assessed the impact of ATO on clinical outcomes. Methods: This single-center retrospective study reviewed the effect of a passive ATO strategy by comparing 100 adult patients with an ATO matched by infection type to 100 antibiotic-treated adult patients lacking an ATO note. Results: No difference in clinical outcomes was observed, however, ATO did result in improved optimization of antibiotic selection and duration, and reduction of piperacillin/tazobactam and vancomycin use. Conclusion: Further studies are warranted to evaluate the impact of ATO on clinical outcomes of a larger homogenous population with specified infectious diagnoses and clinical characteristics.

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