SHM Converge Scientific Abstract ePoster Gallery-Contingency Antibiotics in People Who Inject Drugs With Infective Endocarditis

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This project addresses contingency antibiotic prescribing for people who inject drugs (PWID) hospitalized with injection drug use–associated infective endocarditis (IDU-IE). The usual standard of care is prolonged IV antibiotics in a supervised medical setting, but PWID are more likely to leave before medically advised (BMA), increasing the risk of poor outcomes. Prior evidence suggests that prescribing contingency antibiotics—such as long-acting injectable or oral options—at BMA discharge can reduce readmissions and mortality.<br /><br />The aim was to increase contingency antibiotic prescribing at BMA discharge in PWID with IDU-IE. The team completed a pre-intervention chart review of 60 adults admitted between 2020 and 2022, examining whether a contingency plan was documented, discharge disposition, and whether contingency antibiotics were prescribed. They also surveyed hospitalists, hospital medicine advanced practice providers, and internal medicine residents about their perceptions and barriers. The intervention included educational lectures and the creation of an Epic dot phrase to support standardized contingency planning.<br /><br />Key findings from the pre-intervention assessment showed that documented contingency antibiotic plans were associated with a higher likelihood of prescription at BMA discharge. Surveyed providers generally recognized the importance of documenting contingency plans and prescribing antibiotics, but identified major barriers including time constraints, absence of a documented plan, and complexity of the plan.<br /><br />The authors conclude that improving documentation may increase contingency antibiotic prescribing. A post-intervention chart review is planned to evaluate whether the educational and documentation tools improve practice.

Asset Subtitle

Haley Probst

Meta Tag

Author List Fay Osman, Haley Probst, Jessica Tischendorf, Jordan Kenik, Rosemary Bailey

Category Innovations

Concept Infective Endocarditis

Concept Contingency Antibiotic Prescription

Concept Intravenous Drug Use

Concept Before Medically Advised Discharge

Concept Long-Acting Injectable Antibiotic

Distinguished Non-Finalist

Presenter Organization University of Wisconsin Hospitals and Clinics

Presenting Author Haley Probst

Track Quality Improvement

Keywords

contingency antibiotic prescribing

PWID

infective endocarditis

BMA discharge

long-acting injectable antibiotics

oral antibiotics

documentation

Epic dot phrase

hospitalist education

readmission reduction

Infective Endocarditis

Contingency Antibiotic Prescription

Intravenous Drug Use

Before Medically Advised Discharge

Long-Acting Injectable Antibiotic