A discharge summary that says 'oral co-amoxiclav for five days' is ambiguous from the moment it is written. Five days from admission, from the switch to oral, or from discharge? The receiving clinician cannot tell, the patient cannot tell, and the default resolution is that the course runs longer than anyone intended.
The fix takes four words: write the date the antibiotic stops. 'Co-amoxiclav 625 mg three times daily, stop after the dose on 24 September' cannot be misread, survives a handover, and gives the community pharmacist something to check the supply against.
The same applies to anything with a defined end: a reducing steroid course, post-operative anticoagulation, a proton pump inhibitor started for stress ulcer prophylaxis in intensive care. Prophylactic acid suppression started on a ward and never stopped is one of the commonest unintended long-term prescriptions in medicine, and it persists for exactly this reason — nobody wrote down when it ends.
- Put a calendar stop date on every time-limited prescription in the discharge summary
- Name who is responsible for stopping it — the patient, the GP, or the clinic
- Review at discharge every drug started during admission for a reason that has now passed
- Acid suppression started for prophylaxis is the one most often missed
Why it matters
Most unintended long-term prescriptions begin as a short course that nobody recorded an end date for.
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