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• Facility-specific treatment recommendations, based on national guidelines and local susceptibility patterns for common clinical syndromes are a core element of hospital antimicrobial stewardship programs. • CCHS is a Cerner based, 1,200 bed community, teaching health system with approximately 185,000 total ED visits amongst 3 ED locations with 2,000 PNA ED visits, and 1,200 PNA admissions per year. • The CCHS ASP provides recommendations on IAbxR based on national guidelines, local resistance patterns, and the hospital formulary. • Survival and quality of care is directly related to the selection of the IAbxR for PNA. • Historically, CCHS ED provider compliance with IAbxR was 55%, with the major gap being overutilization of fluoroquinolones in the absence of a severe β-lactam allergy. • Barriers to optimal antibiotic selection include multiple modes for ordering antibiotics for PNA through CPOE system, variety of tertiary references not considering local resistance patterns or formulary, and provider knowledge gaps. BACKGROUND

Enhancing Antimicrobial Stewardship for Pneumonia in the Emergency Department Utilizing a Clinical Decision Support Tool