Obez C, Barisic AM, Chatelier W, Dellamonica MC, Falcot J, Koubi C, Mondain V, Dellamonica P. [The computer-assisted management programs for antibiotic therapies in connection with an application in geriatrics].
PATHOLOGIE-BIOLOGIE 2004;
52:589-96. [PMID:
15596308 DOI:
10.1016/j.patbio.2004.07.023]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2004] [Accepted: 07/13/2004] [Indexed: 05/01/2023]
Abstract
OBJECTIVES
Improve antibiotic therapies in a geriatrics hospital by enhancing guidelines impact. Historical background. - Study of the uses of the data-processing tool: detection of adverse drug events and inappropriate therapies; diffusion of the probable bacteria and their sensitivities to antibiotics following the infected site; creating decisional algorithms leading to suggested antibiotic therapy concept.
METHOD
Referring to the conferences of consensus: drafting of local protocols of antibiotic therapies by using data processing if possible. Description of computer-systems implemented in Salt Lake City (USA) and Tubingen (Germany). With the assistance of an expert infectiologist, design of a database containing clinical details of the different situations in the pulmonary and urinary infections: once the clinical data are entered, a suggested antibiotic therapy appears on the screen, followed by a suggested prescription adapted to patient's specifications. During five years, survey of Defined Daily Dose per 1000 occupied bed-days; survey of sensitivities to antibiotics of urinary tract bacteria.
RESULTS
Decrease of overall antibiotic consumption; decrease of broad-spectrum agents; modifications of E. coli sensitivities lead to variations of suggested antibiotic therapy.
DISCUSSION
Seizure of the clinical determinants imposes a reducing effect; but it is necessary to apply to antibiotic therapies a hierarchicalbasis on account of bacterial resistances process and on account of "tonnage" of antibiotic prescriptions.
CONCLUSION
Computer-assisted decision in antibiotic therapy can draw prescribers' attention to guidelines. The adhesion of the physicians to the computerized decision-making system is consolidated by their direct participation in the design of this system.
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