Impact of an Interruptive Alert on the Number of Women Receiving CDC-Recommended Therapy for Trichomoniasis.

The 2021 Centers of Disease Control and Prevention (CDC) sexually transmitted infection treatment guidelines recommend a 7-day course of metronidazole or single-dose tinidazole for women with trichomoniasis due to improved patient outcomes compared with single-dose metronidazole therapy. A health system antimicrobial stewardship program implemented an interruptive electronic health record (EHR) alert to promote optimal trichomoniasis prescribing when nonrecommended treatment is ordered. To determine the impact of an interruptive EHR alert on optimal trichomoniasis prescribing for women. This was an institutional review board-approved, single pretest, posttest quasi-experiment of women ≥15 years with a microbiologically confirmed infection from 10/2023 to 12/2023 (preintervention) and 10/2024 to 12/2024 (postintervention). An EHR alert was implemented 9/2024 that notifies prescribers that single-dose metronidazole 2 g is not recommended and suggests CDC-recommended treatments. The primary outcome was the proportion of single-dose metronidazole 2 g orders before and after EHR alert implementation. A secondary cross-sectional evaluation of all alerts triggered from 10/2024 to 12/2024 was performed and included the number of alerts, location of alert, and provider response. A total of 285 patients were included, 49.8% pre-intervention and 50.2% postintervention. Metronidazole 2 g was prescribed for 8.45% of pre-intervention and 2.80% of postintervention patients ( = 0.038). The clinical support alert fired 102 times for 75 patients during the 3-month postimplementation period. The alert was associated with a change in intended prescription to a metronidazole 7-day course in greater than 60% of patients over 3 months. The implementation of an interruptive alert was associated with high acceptance and improved prescribing for women treated for trichomoniasis.