A Clinical Decision Support System for an Antimicrobial Stewardship Program
F. Palacios, M. Campos, J. M. Juarez, S. E. Cosgrove, E. Avdic, B. Canovas-Segura, A. Morales, M. E. Martínez-Nuñez, T. Molina-García, P. García-Hierro, J. Cacho-Calvo
2016
Abstract
The World Health Organization has declared that antimicrobial resistance is a major public health issue and one of the three greatest threats to human health. Antimicrobial Stewardship Programs, ASP, are institutional approaches to curb the threat of antimicrobial resistance, improve the safety of patients receiving antibiotics, and decrease antibiotic costs. Medical informatics in all areas, particularly the Electronic Health Record (EHR), has become a paradigm of modern medicine. An intelligent system integrated in EHR can play an important role in facilitating ASP activities. In this article we describe the experience of integration of a newly developed medical decision support system into an antimicrobial stewardship program in a mid-size hospital.
References
- CDC, 2013. Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States. Available from: www.cdc.gov/drugresistance/threatreport-2013/.
- ECDC, 2009. European Centre for Disease Prevention and Control. The bacterial challenge: time to react;. Available from: www.ecdc.europa.eu/en/publications/ Publications/0909_TER_The_Bacterial_Challenge_Ti me_to_React.pdf.
- Doron S, Davidson LE, 2011. Antimicrobial stewardship. Mayo Clin Proc.; 86(11): 1113-23.
- Nathan C, Cars O, 2014. Antibiotic Resistance - Problems, Progress, and Prospects. N Engl J Med.; 371:1761-3.
- Carling P, Fung T, Killion A, Terrin N, Barza M, 2003. Favorable impact of a multidisciplinary antibiotic management program conducted during 7 years. Infect Control Hosp Epidemiol; 24:699-706.
- Blumenthal D, Tavenner M, 2010. The "Meaningful Use" Regulation for Electronic Health Records. N Engl J Med.; 363 (6): 501-504.
- Dellit TH, Owens RC, McGowan JE Jr, Gerding DN, Weinstein RA, Burke JP, et al, 2007. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin. Infect. Dis; 44: 159 - 177.
- CDC, 2012. Institute for Healthcare Improvement. CDC/IHI Antibiotic Stewardship Driver Diagram and Change Package. Available from: http://www.cdc.gov/ getsmart/healthcare/implementation.html.
- Schulz L, Osterby K, Fox B, 2013. The use of best practice alerts with the development of an antimicrobial stewardship navigator to promote antibiotic de-escalation in the electronic medical record. Infect Control Hosp Epidemiol; 34(12): 1259- 65.
- Buchanan BG, Shortliffe EH. 1984. Rule Based Expert Systems: The Mycin Experiments of the Stanford Heuristic Programming Project (The Addison-Wesley Series in Artificial Intelligence). Addison-Wesley Longman Publishing Co., Inc., Boston, MA, USA.
- Evans RS, Pestotnik SL, Classen DC, Clemmer TP, Weaver LK, Orme JF Jr, et al, 1998. A computerassisted management program for antibiotics and other antiinfective agents. N Engl J Med; 338(4):232-8.
- Nachtigall I, Tafelski S, Deja M, Halle E, Grebe MC, Tamarkin A, et al, 2014. Long-term effect of computer-assisted decision support for antibiotic treatment in critically ill patients: a prospective 'before/after' cohort study. BMJ Open;4(12):e005370.
- Pestotnik SL, 2005. Expert clinical decision support systems to enhance antimicrobial stewardship programs: insights from the society of infectious diseases pharmacists; Pharmacotherapy; 25(8):1116- 25.
- Forrest GN, Van Schooneveld TC, Kullar R, Schulz LT, Duong P, and Postelnick M, 2014. Use of Electronic Health Records and Clinical Decision Support Systems for Antimicrobial Stewardship. Clin Infect Dis; 59 (suppl 3): S122-S133.
- Calloway S, Akilo HA, Bierman K, 2013 Impact of a clinical decision support system on pharmacy clinical interventions, documentation efforts, and costs. Hosp Pharm.; 48(9):744-52.
- Avdic E, Carroll KC, 2014. The Role of the Microbiology Laboratory in Antimicrobial Stewardship Programs, Infectious Disease Clinics of North America ; 28(2):215-235.
- Leclercq R, Cantón R, Brown DF, Giske CG, Heisig P, MacGowan AP, et al, 2013. EUCAST expert rules in antimicrobial susceptibility testing. Clin Microbiol Infect; 19(2):141-60.
- Cosgrove SE, Patel A, Song X, Miller RE, Speck K, Banowetz A, et al., 2007. Impact of different methods of feedback to clinicians after postprescription antimicrobial review based on the Centers For Disease Control and Prevention's 12 Steps to Prevent Antimicrobial Resistance Among Hospitalized Adults.
- Infect Control Hosp Epidemiol.; 28(6):641-6.
Paper Citation
in Harvard Style
Palacios F., Campos M., Juarez J., Cosgrove S., Avdic E., Canovas-Segura B., Morales A., Martínez-Nuñez M., Molina-García T., García-Hierro P. and Cacho-Calvo J. (2016). A Clinical Decision Support System for an Antimicrobial Stewardship Program . In Proceedings of the 9th International Joint Conference on Biomedical Engineering Systems and Technologies - Volume 5: HEALTHINF, (BIOSTEC 2016) ISBN 978-989-758-170-0, pages 496-501. DOI: 10.5220/0005824904960501
in Bibtex Style
@conference{healthinf16,
author={F. Palacios and M. Campos and J. M. Juarez and S. E. Cosgrove and E. Avdic and B. Canovas-Segura and A. Morales and M. E. Martínez-Nuñez and T. Molina-García and P. García-Hierro and J. Cacho-Calvo},
title={A Clinical Decision Support System for an Antimicrobial Stewardship Program},
booktitle={Proceedings of the 9th International Joint Conference on Biomedical Engineering Systems and Technologies - Volume 5: HEALTHINF, (BIOSTEC 2016)},
year={2016},
pages={496-501},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0005824904960501},
isbn={978-989-758-170-0},
}
in EndNote Style
TY - CONF
JO - Proceedings of the 9th International Joint Conference on Biomedical Engineering Systems and Technologies - Volume 5: HEALTHINF, (BIOSTEC 2016)
TI - A Clinical Decision Support System for an Antimicrobial Stewardship Program
SN - 978-989-758-170-0
AU - Palacios F.
AU - Campos M.
AU - Juarez J.
AU - Cosgrove S.
AU - Avdic E.
AU - Canovas-Segura B.
AU - Morales A.
AU - Martínez-Nuñez M.
AU - Molina-García T.
AU - García-Hierro P.
AU - Cacho-Calvo J.
PY - 2016
SP - 496
EP - 501
DO - 10.5220/0005824904960501