Improving Appropriate Antibiotic Use for Emergency Department Community-Acquired Pneumonia

The Centers for Medicare and Medicaid Services' inpatient quality reporting program includes appropriate antibiotic use among community-acquired pneumonia patients in the emergency department as a performance measure. Montefiore Medical Center convened a multidisciplinary team to define opportunities for improvement and implement and evaluate a solution to ensure appropriate antibiotic use among CAP patients. The team consisted of clinical and administrative personnel from ED, infectious disease, pharmacy and performance improvement groups. Analysis of baseline data showed that the most common cause for failure on the performance measure was omission of macrolide antibiotics from the initial treatment regimen.