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Quality improvement project evaluates antimicrobial orders and infection source selection in hospitals, highlighting future stewardship strategies.
Objective: To evaluate the impact of requiring infectious source selection on systemic antimicrobial orders for stewardship tracking. Design and Setting: Multicenter, health system quality improvement project across 17 hospitals and 21 emergency departments. Methods: All inpatient and ED antimicrobial orders with an indication between September 1 and September 30, 2024 were analyzed. Primary outcome: Prevalence of selected infectious sources. Secondary outcomes: indication frequency, free-text use, and concordance between selected and documented sources in 500 random orders. Results: Among 57,118 orders, empiric indication was most common (71%). Top sources: respiratory (23%), urinary/renal (19%), skin/soft tissue (16%). Concordance was 95%. Free-text entries (2.6%) often matched existing options; dental/oral emerged as a new category. Conclusion: Infectious source selection was evaluated and supports future targeted stewardship interventions.
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Carlone et al. (2026) studied this question.
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