An antibiotic order form intervention does not improve or reduce vancomycin use

Maureen K Bolon*, Alana D. Arnold, Henry A. Feldman, Donald A. Goldmann, Sharon B. Wright

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations


Objectives: To determine whether a paper-based antibiotic ordering system is an effective antibiotic stewardship measure. Methods: An antibiotic order form (AOF) was introduced in July 2001 at a pediatric tertiary care hospital. Vancomycin courses prescribed before and after the AOF introduction were retrospectively reviewed based on Hospital Infection Control Practices Advisory Committee guidelines. The impact of the AOF on the appropriateness of vancomycin prescribing was evaluated in univariate and multivariable analyses that adjusted for other factors associated with appropriateness of vancomycin use. The density of vancomycin use after introduction of the AOF was also assessed. Results: Compliance with the AOF was poor (<50%) during the planned study period; therefore an additional 2 months of improved compliance (70-80%) were included. Rates of inappropriate vancomycin use increased during the study periods: 35% before AOF; 39% post-AOF; and 51% during the improved compliance period. On adjusted analysis, vancomycin utilization was significantly more inappropriate after introduction of the AOF. Vancomycin doses per 1000 patient days increased after introduction of the AOF. Conclusions: Inappropriate vancomycin use and vancomycin use overall increased after the introduction of an AOF. An AOF intervention did not have its intended effect of improving and reducing vancomycin use.

Original languageEnglish (US)
Pages (from-to)1053-1058
Number of pages6
JournalPediatric Infectious Disease Journal
Issue number12
StatePublished - Jan 1 2005


  • Drug utilization review
  • Practice guidelines
  • Vancomycin

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases


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