[The computer-assisted management programs for antibiotic therapies in connection with an application in geriatrics].
OBJECTIVE
Improve antibiotic therapies in a geriatrics hospital by enhancing guidelines impact. Historical background. - Study of the uses of the data-processing tool: detection of adverse drug events and inappropriate therapies; diffusion of the probable bacteria and their sensitivities to antibiotics following the infected site; creating decisional algorithms leading to suggested antibiotic therapy concept.


METHODS
Referring to the conferences of consensus: drafting of local protocols of antibiotic therapies by using data processing if possible. Description of computer-systems implemented in Salt Lake City (USA) and Tubingen (Germany). With the assistance of an expert infectiologist, design of a database containing clinical details of the different situations in the pulmonary and urinary infections: once the clinical data are entered, a suggested antibiotic therapy appears on the screen, followed by a suggested prescription adapted to patient's specifications. During five years, survey of Defined Daily Dose per 1000 occupied bed-days; survey of sensitivities to antibiotics of urinary tract bacteria.


RESULTS
Decrease of overall antibiotic consumption; decrease of broad-spectrum agents; modifications of E. coli sensitivities lead to variations of suggested antibiotic therapy.


CONCLUSIONS
Seizure of the clinical determinants imposes a reducing effect; but it is necessary to apply to antibiotic therapies a hierarchicalbasis on account of bacterial resistances process and on account of "tonnage" of antibiotic prescriptions.


CONCLUSIONS
Computer-assisted decision in antibiotic therapy can draw prescribers' attention to guidelines. The adhesion of the physicians to the computerized decision-making system is consolidated by their direct participation in the design of this system.
Obez
C
C
Unité des soins intensifs, clinique Les-Sources, CHU de Nice, 10, Camin-René-Pietruschi, 06100 Nice, France. christophe.obez@wanadoo.fr
Barisic
A-M
AM
Chatelier
W
W
Dellamonica
M-C
MC
Falcot
J
J
Koubi
C
C
Mondain
V
V
Dellamonica
P
P
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004360:Drug Therapy, Computer-Assisted / Q000379:methods*; D005853:Geriatrics; D006801:Humans; D007239:Infections / Q000188:drug therapy*; D012680:Sensitivity and Specificity
D000900:Anti-Bacterial Agents