Bibliographic Details
| Title: |
Decision support during electronic prescription to stem antibiotic overuse for acute respiratory infections: a long-term, quasi-experimental study |
| Authors: |
Jeneen Gifford, Elisabeth Vaeth, Katherine Richards, Tariq Siddiqui, Christine Gill, Lucy Wilson, Sylvain DeLisle |
| Source: |
BMC Infectious Diseases, Vol 17, Iss 1, Pp 1-8 (2017) |
| Publisher Information: |
BMC, 2017. |
| Publication Year: |
2017 |
| Collection: |
LCC:Infectious and parasitic diseases |
| Subject Terms: |
Infectious and parasitic diseases, RC109-216 |
| More Details: |
Abstract Background Interventions to support decision-making can reduce inappropriate antibiotic use for acute respiratory infections (ARI), but they may not be sustainable. The objective of the study is to evaluate the long-term effectiveness of a clinical decision-support system (CDSS) interposed at the time of electronic (e-) prescriptions for selected antibiotics. Methods This is a retrospective, observational intervention study, conducted within a large, statewide Veterans Affairs health system. Participants are outpatients with an initial visit for ARI. A CDSS was deployed upon e-prescription of selected antibiotics during the study period. From 01/2004 to 05/2006 (pre-withdrawal period), the CDSS targeted azithromycin and the fluoroquinolone gatifloxacin. From 05/2006 to 12/2011 (post-withdrawal period), the CDSS was retained for azithromycin but withdrawn for the fluoroquinolone. A manual record review was conducted to determine concordance of antibiotic prescription with ARI treatment guidelines. Results Of 1131 included ARI visits, 380 (33.6%) were guideline-concordant. For azithromycin, concordance did not change between the pre- and post-withdrawal periods, and adjusted odds of concordance was 8.8 for the full study period, compared to unrestricted antibiotics. For fluoroquinolones, guideline concordance decreased from 88.6% (39 of 44 visits) to 51.3% (59 of 115 visits), pre- vs. post-withdrawal periods (p |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1471-2334 |
| Relation: |
http://link.springer.com/article/10.1186/s12879-017-2602-7; https://doaj.org/toc/1471-2334 |
| DOI: |
10.1186/s12879-017-2602-7 |
| Access URL: |
https://doaj.org/article/a0cd5be28b114c1caf154bfb1f53f8fb |
| Accession Number: |
edsdoj.0cd5be28b114c1caf154bfb1f53f8fb |
| Database: |
Directory of Open Access Journals |
