Clinical Decision Support Systems and Their Role in Antibiotic Stewardship: a Systematic Review

被引:52
作者
Rittmann, Barry [1 ,2 ]
Stevens, Michael P. [1 ]
机构
[1] Virginia Commonwealth Univ Hlth Syst, Richmond, VA 23284 USA
[2] 825 Fairfax Ave,4th Floor, Norfolk, VA 23507 USA
关键词
Clinical decision support system; CDDS; Decision support system; Antibiotic stewardship; Antimicrobial stewardship; FOR-DISEASE-CONTROL; ANTIMICROBIAL STEWARDSHIP; EMERGENCY-DEPARTMENT; IMPACT; CARE; IMPLEMENTATION; GUIDELINES; INTERVENTION; GENTAMICIN; PROGRAM;
D O I
10.1007/s11908-019-0683-8
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Purpose of ReviewThe purpose of this article is to perform a systematic review over the past 5years on the role and effectiveness of clinical decision support systems (CDSSs) on antibiotic stewardship.Recent FindingsCDDS interventions found a significant impact on multiple outcomes relevant to antibiotic stewardship. There are various types of CDSS implementations, both active and passive (provider initiated). Passive interventions were associated with more significant outcomes; however, both interventions appeared effective. In the reviewed literature, CDSSs were consistently associated with decreasing antibiotic consumption and narrowing the spectrum of antibiotic usage. Generally, guideline adherence was improved with CDSS, although this was not universal. The effect on other outcomes, such as mortality, Clostridiodes difficile infections, length of stay, and cost, inconsistently showed a significant difference.SummaryOverall, CDDS implementation has effectively decreased antibiotic consumption and improved guideline adherence across the various types of CDSS. Other positive outcomes were noted in certain settings, but were not universal. When creating a new intervention, it is important to identify the optimal structure and deployment of a CDSS for a specific setting.
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页数:12
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