Impact of a computerized clinical decision support system on reducing inappropriate antimicrobial use: A randomized controlled trial

Team intervened in 16% of patient cases in intervention arm vs 8% in control arm and spent one hour less per day with the intervention arm. Hospital expenditures were $285,812 vs. $370,000 in control arm over 3 months. No significant difference in mortality. Clostridium difficile super infection NS/3 months.

Reference:
McGregor JC, Weekes E, Forrest GN, Staniford HC, Perencevich EN, Furuno JP, and Harris AD. Impact of a Computerized Clinical Decision Support System on Reducing Inappropriate Antimicrobial Use: A Randomized Controlled Trial. J Am Med Inform Assoc. 2006; 13: 378-384

Setting:
648-bed, tertiary-care teaching hospital, Baltimore, MD, USA

Key staff:
Infectious disease physician and clinical pharmacist

Intervention:
Electronic Monitoring – randomized controlled trial  of active monitoring by antimicrobial management team of all restricted antibiotic orders with a computer system compared to a group without the computer system to alert for inadequate antimicrobial therapy.

Impact:
Team intervened in 16% of patient cases in intervention arm vs 8% in control arm and spent one hour less per day with the intervention arm. Hospital expenditures were $285,812 vs. $370,000 in control arm over 3 months. No significant difference in mortality. Clostridium difficile super infection NS/3 months.

Tools:
Computerized monitoring software