Antibiotic Approvals Help
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The Antibiotic Approvals module is designed for pharmacists handling phone-based antibiotic approval requests. Unlike system-generated alerts, these requests are initiated manually when a prescriber calls requesting extended use of broad-spectrum antibiotics (e.g., meropenem past 72 hours).
Workflow
Receive Call
Prescriber calls requesting antibiotic approval for a patient.
Search for Patient
Click "New Request" and search by MRN (recommended) or patient name.
Review Clinical Alerts
Check the Clinical Alerts card for MDR history, drug allergies, and renal status that may affect antibiotic selection.
Review Cultures & Medications
Review current antibiotics and recent culture/susceptibility results. Allergy-unsafe options are flagged.
Document Request
Enter the antibiotic name, duration, and your decision. Optional details (indication, dose) can be expanded if needed.
Submit
Your decision is recorded and the request is documented for compliance and reporting.
Decision Types
The requested antibiotic is appropriate. The prescriber may continue therapy.
Recommend a different antibiotic. Enter the recommended alternative.
Complex case requiring Infectious Disease consultation. Provide rationale in the notes.
Need more information. Plan to call back after reviewing additional data.
Clinical Alerts
The Clinical Alerts card displays critical patient information that may affect antibiotic selection:
MDR Pathogen History
Shows if the patient has had resistant organisms in the past year:
- MRSA Methicillin-resistant Staphylococcus aureus
- VRE Vancomycin-resistant Enterococcus
- CRE Carbapenem-resistant Enterobacteriaceae
- ESBL Extended-spectrum beta-lactamase producer
Drug Allergies
Lists documented drug allergies with severity. Life-threatening allergies (anaphylaxis) are highlighted. Culture susceptibility options that conflict with patient allergies are flagged with a warning icon.
Renal Function
Displays CKD stage, dialysis status, and recent creatinine/GFR values. Patients with GFR < 30 or on dialysis may require dose adjustments.
Common Antibiotics Requiring Approval
The following broad-spectrum antibiotics commonly require pharmacist approval for extended use:
- Carbapenems: Meropenem, Imipenem, Ertapenem
- Extended-spectrum cephalosporins: Cefepime, Ceftazidime
- Anti-MRSA agents: Vancomycin, Daptomycin, Linezolid
- BL/BLI combinations: Piperacillin-Tazobactam, Ceftazidime-Avibactam
- Fluoroquinolones: Levofloxacin, Ciprofloxacin, Moxifloxacin
Best Practices
- Always verify the patient identity with the prescriber before proceeding.
- Review recent culture results to assess antibiotic appropriateness.
- Check current antibiotic orders to avoid duplication or inappropriate combinations.
- Document the clinical indication clearly for compliance tracking.
- When recommending therapy changes, ensure the alternative covers the suspected pathogens.
- Use the "Deferred" option if you need additional clinical context before deciding.
Reports
The Reports page provides analytics on approval patterns, including:
- Decision breakdown (approval rate, therapy changes, denials)
- Most frequently requested antibiotics
- Response time metrics
- Trends by day of week and daily volume
Use these reports for stewardship program metrics and quality improvement initiatives.
Need Assistance?
For technical issues with this dashboard, contact the AEGIS support team.
For clinical questions about antibiotic stewardship, contact the Antimicrobial Stewardship Program.