Dose O'Clock: Timely Antibiotic Redosing in the Emergency Department

Document Type

Conference Proceeding

Publication Date

3-6-2026

Publication Title

Am J Health Syst Pharm

Keywords

Pharmacology & Pharmacy

Abstract

Purpose: Timely and appropriate antibiotic redosing in the emergency department (ED) is essential, especially in cases where patient disposition is delayed and boarding times are prolonged. Delays or inappropriate redosing can result in subtherapeutic exposure, increased risk of treatment failure, and the development of antimicrobial resistance. Currently, most intravenous (IV) antibiotics in the ED are ordered as one-time doses and require manual evaluation for redosing. The purpose of this study will be to describe the proportion of patients receiving timely redosing of IV antibiotics according to institutional dosing guidelines. Methods: This retrospective study will include adults (≥ 18 years) treated in the Henry Ford Hospital Detroit ED from 08/01/2024 to 08/01/2025 who received at least two doses of the same IV antibiotic prior to hospital admission or ED discharge. In this study, we look to evaluate pharmacist involvement in the dispensing of antibiotics in the ED and delays in therapy administration. The primary objective will be to evaluate the prevalence of patients who experienced delayed second antibiotic doses (defined as >125% of the initial dosing interval) following the addition of a second ED pharmacist. Secondary objectives will include appropriateness of antibiotic therapy according to institutional protocol and patient-specific factors, timeliness of subsequent doses, time from order entry to administration, and compliance with the institutional sepsis protocol. Patients will be excluded if they are pregnant, cognitively impaired, incarcerated, end stage renal disease, transferred from another ED or hospital, unidentified on ED arrival, have scheduled antibiotics, or documented refusal of administration. Vancomycin dosing in patients with acute kidney injury and all aminoglycoside dosing will be excluded. Data will be analyzed using measures of central tendency with mean with standard deviation or median with interquartile range, where appropriate. Collection bias will be addressed by standardized collection form and objectively defined data points. This study has been submitted to the IRB and is awaiting approval.

Volume

83

First Page

S807

Find It @ Sladen

Share

COinS