Decision support systems for antibiotic prescribing.
OBJECTIVE
To explore recent developments in computerized evidence-based guidelines and decision support systems that have been designed to improve the effectiveness and efficiency of antibiotic prescribing.


RESULTS
The most frequently utilized decision support systems are electronic guidelines and protocols, especially for empirical selection of antibiotics. The majority of decision support systems result in improvement in clinical performance and, in at least half of the published trials, in patient outcomes. Despite the reported successes of individual applications, the safety of electronic prescribing systems in routine practice has been identified recently as an issue of potential concern. Bioinformatics-assisted prescribing may contribute to reducing the complexities of prescribing combinations of antimicrobials in the era of multidrug resistance.


CONCLUSIONS
The reemerging interest in prescribing decision support reflects the recent change in emphasis from support for diagnostic decisions towards support for patient management and from systems targeting a broad range of clinical diagnoses to task specific and condition-specific decision aids.
Sintchenko
Vitali
V
Centre for Infectious Diseases and Microbiology, Level 3, ICPMR,Westmead Hospital, Westmead, NSW 2141, Australia. vitali.sintchenko@swahs.health.nsw.gov.au
Coiera
Enrico
E
Gilbert
Gwendolyn L
GL
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D003658:Decision Making, Computer-Assisted; D020000:Decision Support Systems, Clinical; D006801:Humans; D055656:Prescriptions
D000900:Anti-Bacterial Agents