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  1. Improving empirical antibiotic treatment : prospective, nonintervention testing of a decision support system.

    Article - En anglais

    Leibovici L, Gitelman V. Yehezkelli Y, Poznanski O, Milo G, Paul M & Ein-dor P (Rabin Medical Centre, Petah-Tiqva, Sackler Faculty of Medicine, and Faculty of Management, Tel-Aviv University, Ramat-Aviv, Tel-Aviv, Israel).

    Improving empirical antibiotic treatment : prospective, nonintervention testing of a decision support system.

    Objectives

    Develop a problem-orientated and data-based decision support system (DSS) to improve empirical antibiotic treatment, and compare the performance of the system to that of the physician.

    Design

    The DSS was tested in a prospective, noninterventional, comparative cohort study.

    Setting

    University hospital in Israel.

    Subjects

    Consecutive patients (n=496) in four departments of internal medicine suspected of harboring a moderate to severe bacterial infection.

    Interventions

    None.

    Main outcome measures

    The percentage of appropriate empirical antibiotic treatments.

    Results

    Out of 496 patients included in the study, 219 had positive cultures or serological tests.

    The physicians prescribed inappropriate empirical antibiotic treatment in 91 of 219 patients (42%) ; whilst the recommendations of the system were inappropriate in 50 patients (23%) (P<0.05).

    Superfluous treatment was prescribed in 15% of patients by the physician, and in 11% by the system.

    Out of the 91 patients given inappropriate treatment by the physician, the DSS advised treatment to which the pathogens were susceptible in 61 patients. (...)

    Mots-clés Pascal : Antibiotique, Traitement, Epidémiologie, Système aide décision, Prospective, Etude cohorte, Facteur prédictif, Exploration bactériologique, Relation médecin malade, Spectre diffusion, Evaluation, Homme, Chimiothérapie, Politique sanitaire

    Mots-clés Pascal anglais : Antibiotic, Treatment, Epidemiology, Decision support system, Prospective, Cohort study, Predictive factor, Bacteriological investigation, Physician patient relation, Diffusion spectra, Evaluation, Human, Chemotherapy, Health policy

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

    Cote : 98-0028013

    Code Inist : 002B02S07. Création : 17/04/1998.