Computerized antimicrobial decision support: an offline evaluation of a database-driven empiric antimicrobial guidance program in hospitalized patients with a bloodstream infection

Authors: 
Mullett, C. J., Thomas, J. G., Smith, C. L., Sarwari, A. R., Khakoo, R. A.
Journal: 
Int J Med Inform
Publication Date: 
2004 Jun 15
Volume: 
73
Issue: 
5
Pages: 
455-60
  • HIT Description: decision support Ð clinical guidelines More info...
  • Purpose of Study: test the safety and efficacy of the program in a retrospective analysis of patients with positive blood cultures
  • Years of study: 2002
  • Study Design: other predictive analysis
  • Outcomes: impact on health care effectiveness and quality
Summary:
  • Settings: West Virginia University Hospital - a 450-bed academic tertiary care center
  • Intervention: Compare antibiotic selection by treating physicians for patients with positive blood cultures to antimicrobial recommendations from the microbiologic decision support tool
  • Evaluation Method: electronic chart review, results from computerized tool
  • Description: antimicrobial recommendations are generated through a multi-step process that includes a case-matching algorithm evaluating previous cultures in the patient, ranking of susceptibility measurements for past cultures, selection of candidate antimicrobials based on patient factors, recommendation of antimicrobial based on cost, toxicity and environmental impact factors
  • Quality of Care and Patient Safety Outcome: Physicians initiated effective empiric therapy at a rate of 66% compared to the computer-guided recommendation effectiveness of 86%.