Use of a physician order entry system to identify opportunities for intravenous to oral levofloxacin conversion.

Experience with a program for identifying, through a physician order entry system, potentially inappropriate use of expensive intravenous (i.v.) drugs, including levofloxacin, is described. The program identifies patients who are receiving i.v. levofloxacin and simultaneously receiving oral medications or an oral diet. A computerized report of such patients is printed every morning at the hospital and distributed to pharmacists according to their nursing station assignments. The pharmacists document their daily interventions to encourage switching from i.v. to oral therapy, and data are compiled and posted at the end of each month. From January 1 through September 30, 1999, the first 10 months of the program, the cost per day of levofloxacin therapy per patient decreased substantially. The program helped the institution decrease the number of patients receiving i.v. levofloxacin.