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  1. Implementing antibiotic practice guidelines through computer-assisted decision support : Clinical and financial outcomes.

    Article - En anglais

    Objective 

    To determine the clinical and financial outcomes of antibiotic practice guidelines implemented through computer-assisted decision support.

    Design 

    Descriptive epidemiologic study and financial analysis.

    Setting 

    520-bed community teaching hospital in Salt Lake City, Utah.

    Patients 

    All 162 196 patients discharged from LDS Hospital between 1 January 1988 and 31 December 1994.

    Intervention 

    An antibiotic management program that used local clinician-derived consensus guidelines embedded in computer-assisted decision support programs.

    Prescribing guidelines were developed for impatient prophylactic, empiric, and therapeutic uses of antibiotics.

    Measurements 

    Measures of antibiotic use included timing of preoperative antibiotic administration and duration of postoperative antibiotic use.

    Clinical outcomes included rates of adverse drug events, patterns of antimicrobial resistance, mortality, and length of hospital stay.

    Financial and use outcomes were expressed as yearly expenditures for antibiotics and defined daily doses per 100 occupied bed-days.

    Results 

    During the 7-year study period, 63 759 hospitalized patients (39.3%) received antibiotics.

    The proportion of the hospitalized patients who received antibiotics increased each year, from 31.8% in 1988 to 53.1% in 1994.

    Use of broad-spectrum antibiotics increased from 24% of all antibiotic use in 1988 to 47% in 1994.

    The annual Medicare case-mix index increased from 1.7481 in 1988 to 2.0520 ...

    Mots-clés Pascal : Antibiotique, Thérapie, Prévention, Assistance ordinateur, Préopératoire, Postopératoire, Résistance traitement, Résultat, Coût, Epidémiologie, Homme, Informatique

    Mots-clés Pascal anglais : Antibiotic, Therapy, Prevention, Computer aid, Preoperative, Postoperative, Negative therapeutic reaction, Result, Costs, Epidemiology, Human, Computer science

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0273696

    Code Inist : 002B30A01A1. Création : 199608.