Antibiotic Stewardship Tracking Log

This template records each antibiotic start in a nursing home and captures the details needed for stewardship review. It is designed to document the indication, whether McGeer or Loeb criteria were used, the planned and actual duration, and whether pharmacist or medical director review happened. Use it to create a consistent audit trail for monthly review and follow-up.

The log is usually completed by nursing leadership, infection prevention staff, a unit coordinator, or the person assigned to stewardship reporting. Pharmacists and medical directors may add review notes, but the form should have one clear owner for submission. If your facility uses delegated data entry, keep the submitted_by field specific so the audit trail stays clear.

This template is built as a monthly log, so entries should be captured as antibiotic starts occur and then reviewed at month-end. Waiting until the end of the month often leads to missing start dates, unclear indications, and incomplete follow-up fields. If your facility prefers weekly review, you can still use the same structure and roll it up monthly for reporting.

No. It is a tracking log, not a clinical order form or a substitute for the medical record. The template helps document stewardship review, but the prescriber’s chart note, medication administration record, and facility policies remain the source of truth for treatment decisions. Use the log to summarize and monitor, not to authorize therapy.

The criteria_used, criteria_met, and criteria_details fields let you record whether the antibiotic start was reviewed against McGeer or Loeb criteria, or another facility-approved standard. That makes it easier to see when treatment aligned with the chosen criteria and when it did not. If your facility uses a different framework, you can customize the field values without changing the overall log structure.

Common issues include leaving the indication too vague, marking every field required, and failing to distinguish a new start from a restart. Another frequent problem is recording duration without checking whether the actual duration matched the planned duration. The log works best when each entry is specific enough to support review and follow-up later.

Yes. The facility_unit field can be adapted for memory care, skilled nursing, long-term care, or a specific wing. You can also add conditional logic for infection_site or follow_up_required so users only see fields that apply. Keep the form focused on the minimum necessary data so it stays usable.

After submission, the entry should route to the assigned reviewer or tracking owner for follow-up, such as pharmacist review, medical director review, or clarification of duration. The attestation should confirm the entry is complete and accurate to the best of the submitter’s knowledge. If your workflow supports it, send a confirmation and create an audit trail for later review.