From a forthcoming article coauthored by Koppel.
1. Housestaff are often eager to try new, expensive antimicrobials.
2. But ID fellows must approve their use. ID fellows use CPOEs and EMRs to examine antimicrobial med orders.
So, 3, Housestaff developed stealth dosing. They wait until the ID fellows go off-duty at 10 PM to order restricted antimicrobials.