Sharpening Empiric Antibiotic Decisions at a Community Hospital
240-bed community hospital · Antimicrobial stewardship program · inpatient · 6 min read
A community hospital's antimicrobial stewardship program used Prescient's AMR resistance scoring to give prescribers a patient-specific resistance risk at the point of empiric ordering — while culture and sensitivity results were still pending. This layered patient-level risk on top of the unit-level antibiogram the team already relied on.
At a Glance
- Organization
- 240-bed community hospital
- Scope
- Inpatient empiric prescribing
- Team involved
- Antimicrobial stewardship program
- EHR environment
- Single EHR, HL7 FHIR integration
- Pillar deployed
- AMR Resistance Scoring
- Time to go-live
- ~7 weeks from discovery
Representative example. This is an illustrative case study built from an anonymized customer archetype to show the shape of a Prescient engagement and its reporting. The scenario and all figures are representative examples, not published results from a named customer.
Results at a Glance
What Changed
Illustrative figures — representative of the reporting structure, not published results.
The Challenge
Where they started
Empiric antibiotic selection at the hospital leaned heavily on unit-level antibiograms. Those aggregate patterns are useful, but they miss the resistance risk factors specific to an individual patient — prior cultures, recent antibiotic exposure, facility transfers, and device history.
In the 24–72 hours before cultures and sensitivities returned, prescribers had no systematic, patient-level view of resistance risk. The stewardship team wanted to add that view without bolting a separate system onto the prescribing workflow.
- Empiric antibiotic selection leaned on unit-level antibiograms alone, which miss patient-specific resistance risk factors.
- Prescribers had no systematic view of an individual patient's resistance risk in the 24–72 hours before cultures returned.
- The stewardship team wanted patient-level visibility without adding a separate system to the prescribing workflow.
The Solution
Patient-level resistance risk at the point of prescribing
Prescient's resistance score was developed in partnership with the stewardship program and calibrated against the hospital's own local resistance patterns, then validated against the facility's culture history before it ever surfaced to a prescriber.
At go-live, the patient-specific resistance risk began appearing alongside standard antibiogram guidance inside the existing empiric prescribing workflow — with the contributing factors shown, so the prescriber saw why a patient was flagged as higher risk.
How data flowed in this deployment
Prior cultures, antibiotic exposure, and facility transfer history.
Patient-specific risk blended with local resistance patterns.
Resistance risk surfaces alongside the antibiogram at order time.
Culture results confirm or adjust; the score updates going forward.
The Approach
How the Deployment Unfolded
- Weeks 1–3Partnership with stewardship
Scoring was developed in partnership with the antimicrobial stewardship program and calibrated against the hospital's local resistance patterns.
- Weeks 4–6Validation against local data
The resistance score was validated against the facility's own culture history before surfacing to prescribers.
- Week 7Go-live at point of prescribing
The patient-level resistance risk began surfacing alongside the empiric prescribing workflow, next to standard antibiogram guidance.
- OngoingStewardship review
As culture results returned, the stewardship team reviewed therapy alignment and the score updated for similar future cases.
The Results
Measured Against Their Own Baseline
Empiric therapy alignment — illustrative before/after
Illustrative example only, not a published result — calibrated to and measured against the facility's own resistance patterns.
Empiric therapy aligned with eventual sensitivity
Illustrative trend as prescribers and stewardship incorporated the score into empiric decisions.
Key Takeaways
What Made It Work
Patient-level resistance risk layered onto — not replaced — the existing antibiogram.
Scoring was calibrated and validated against the facility's own local resistance data.
The risk surfaced inside existing order entry, adding no new system for prescribers.
It informs empiric therapy; the prescribing decision remains the clinician's.
It didn't tell us what to prescribe. It gave the prescriber one more patient-specific input at the moment of the decision, instead of the unit average alone. Our stewardship reviews got easier because of it.
Representative quote illustrating the kind of feedback this engagement is designed to produce — not attributed to a named individual.
The Platform Behind This
AMR Resistance Scoring
Score antimicrobial resistance risk before the culture comes back.
Frequently Asked
Questions About This Scenario
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