Antibiotics
Greener Prescribing: A Quasi-Experimental Study of the Environmental Impact of Metronidazole Dosing Interval Optimization
By Alsoubani M, Campion M, Swarup S and 3 others.
Abstract
Background
Antimicrobial administration is a major contributor to healthcare-associated waste. We evaluated the environmental impact of changing the default metronidazole dosing frequency from three-times-daily (TID) to twice-daily (BID) administration in a three-hospital system.
Methods
We conducted a quasi-experimental uncontrolled interrupted time-series study across an integrated health system. Inpatient oral and intravenous metronidazole utilization was assessed from January 2023 through December 2024, before and after a change in the default metronidazole dosing on 1 February 2024. Overall utilization was measured as days of therapy (DOT)/1000 days present (DP), and frequency-specific utilization was standardized as dispensed doses/1000 DP. Plastic waste was estimated using EcoRxChoice, and modeled disposal-related carbon dioxide-equivalent (CO2e) emissions reflected facility-specific incineration and transportation processes.