{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:08:37Z","timestamp":1787018917158,"version":"build-2736575974"},"reference-count":19,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>\n                    Emergency department (ED) practitioners frequently prescribe antibiotics for sepsis and other infections, with quality and performance metrics often influencing broad-spectrum antibiotic selection. This study objective was to evaluate improvements in antibiotic selection in the ED following implementation and revision of sepsis order sets designed to adhere to Centers for Medicare and Medicaid Services sepsis performance measure bundle across time periods. This single-center, retrospective analysis assessed antibiotic orders in the ED across three periods of order set availability: no sepsis order set (period 1), general broad-spectrum order set (period 2), and infectious-source specific order set (period 3). Order rates of narrow-spectrum \u03b2-lactams, extended-spectrum cephalosporins, antipseudomonal \u03b2-lactams, fluoroquinolones, clindamycin, and other agents were assessed. Individual patient encounters with antibiotic orders for period 1 (n = 4228), period 2 (n = 4407), and period 3 (n = 5129) were assessed. Order set use for antibiotic ordering increased across time periods (4% vs 20.6% vs 53.3%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001). Period 3 was associated with an increase in narrow spectrum \u03b2-lactam use (3% vs 3% vs 15.2%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001), a decrease in antipseudomonal \u03b2-lactam use (30.1% vs 36.1% vs 27.7%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001), and a decrease in targeted antibiotics associated with high risk for adverse effects (28% vs 16% vs 6.9%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001). The creation and utilization of an infectious source-specific sepsis antibiotic order set was associated with improved antibiotic ordering trends in the emergency department. This intervention should be considered by hospital antimicrobial stewardship programs.\n                  <\/jats:p>","DOI":"10.1177\/08971900251394123","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T08:51:23Z","timestamp":1762159883000},"page":"309-314","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of Antibiotic Selection in the Emergency Department Following the Implementation of an Infectious Source-Specific Order Set"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3801-2846","authenticated-orcid":false,"given":"Jon","family":"Derringer","sequence":"first","affiliation":[{"name":"Antimicrobial Stewardship Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6971-1903","authenticated-orcid":false,"given":"Cody","family":"Null","sequence":"additional","affiliation":[{"name":"Antimicrobial Stewardship Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4344-1125","authenticated-orcid":false,"given":"Jared","family":"Heiles","sequence":"additional","affiliation":[{"name":"Antimicrobial Stewardship Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3119-7729","authenticated-orcid":false,"given":"Katherine","family":"Lusardi","sequence":"additional","affiliation":[{"name":"Antimicrobial Stewardship Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Novack","sequence":"additional","affiliation":[{"name":"Antimicrobial Stewardship Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9540-2683","authenticated-orcid":false,"given":"Ryan","family":"Dare","sequence":"additional","affiliation":[{"name":"Antimicrobial Stewardship Program"},{"name":"University of Arkansas for Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003613"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1676040"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad677"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy357"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dki180"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002769"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2024.0581"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2201"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2019.04.175"},{"key":"e_1_3_4_12_2","volume-title":"FDA Updates Warnings for Fluoroquinolone Antibiotics","author":"FDA","unstructured":"FDA. FDA Updates Warnings for Fluoroquinolone Antibiotics. U.S. Food and Drug Administration. https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-updates-warnings-fluoroquinolone-antibiotics (Accessed July 26, 2024)."},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad413"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32218-9"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad258"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad588"},{"key":"e_1_3_4_17_2","article-title":"Intrapartum management of intraamniotic infection","author":"American College of Obstetricians and Gynecologists\u2019 Committee on Obstetric Practice","unstructured":"American College of Obstetricians and Gynecologists\u2019 Committee on Obstetric Practice. Intrapartum management of intraamniotic infection. American College of Obstetricians and Gynecologists. https:\/\/www.acog.org\/en\/clinical\/clinical-guidance\/committee-opinion\/articles\/2017\/08\/intrapartum-management-of-intraamniotic-infection (Accessed July 26, 2024).","journal-title":"American College of Obstetricians and Gynecologists"},{"key":"e_1_3_4_18_2","volume-title":"Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data","author":"CLSI","year":"2022","unstructured":"CLSI. Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data. 5th ed., Clinical and Laboratory Standards Institute. 2022. CLSI guideline M39.","edition":"5"},{"key":"e_1_3_4_19_2","volume-title":"Flagyl (metronidazole) [package insert]","year":"2024","unstructured":"Flagyl (metronidazole) [package insert]. New York, NY: Pfizer Inc. 2024."},{"key":"e_1_3_4_20_2","volume-title":"Doxycycline Hyclate Delayed-Release Tablets [package insert]","year":"2016","unstructured":"Doxycycline Hyclate Delayed-Release Tablets [package insert]. Mylan Pharmaceuticals Inc. 2016."}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900251394123","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08971900251394123","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900251394123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T03:56:44Z","timestamp":1782532604000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08971900251394123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,3]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1177\/08971900251394123"],"URL":"https:\/\/doi.org\/10.1177\/08971900251394123","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,3]]}}}