To determine the clinical and financial outcomes of antibiotic practice guidelines implemented through computer-assisted decision support.
Descriptive epidemiologic study and financial analysis.
520-bed community teaching hospital in Salt Lake City, Utah.
All 162 196 patients discharged from LDS Hospital between 1 January 1988 and 31 December 1994.
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.
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.
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
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0273696
Code Inist : 002B30A01A1. Création : 199608.