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Titolo:
A COMPUTER-ASSISTED MANAGEMENT PROGRAM FOR ANTIBIOTICS AND OTHER ANTIINFECTIVE AGENTS
Autore:
EVANS RS; PESTOTNIK SL; CLASSEN DC; CLEMMER TP; WEAVER LK; ORME JF; LLOYD JF; BURKE JP;
Indirizzi:
LATTER DAY ST HOSP,DEPT CLIN EPIDEMIOL,8TH AVE & C ST SALT LAKE CITY UT 84143 LATTER DAY ST HOSP,DEPT CRIT CARE SALT LAKE CITY UT 84143 LATTER DAY ST HOSP,DEPT MED INFORMAT SALT LAKE CITY UT 84143
Titolo Testata:
The New England journal of medicine
fascicolo: 4, volume: 338, anno: 1998,
pagine: 232 - 238
SICI:
0028-4793(1998)338:4<232:ACMPFA>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEALTH-CARE; QUALITY; SURVEILLANCE; SEVERITY; ILLNESS; SYSTEM; COSTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
28
Recensione:
Indirizzi per estratti:
Citazione:
R.S. Evans et al., "A COMPUTER-ASSISTED MANAGEMENT PROGRAM FOR ANTIBIOTICS AND OTHER ANTIINFECTIVE AGENTS", The New England journal of medicine, 338(4), 1998, pp. 232-238

Abstract

Background and Methods Optimal decisions about the use of antibioticsand other antiinfective agents in critically ill patients require access to a large amount of complex information. We have developed a computerized decision-support program linked to computer-based patient records that can assist physicians in the use of antiinfective agents andimprove the quality of care. This program presents epidemiologic information, along with detailed recommendations and warnings. The programrecommends antiinfective regimens and courses of therapy for particular patients and provides immediate feedback. We prospectively studied the use of the computerized antiinfectives-management program for one year in a 12-bed intensive care unit. Results During the intervention period, all 545 patients admitted were cared for with the aid of the antiinfectives-management program. Measures of processes and outcomes were compared with those for the 1136 patients admitted to the same unit during the two years before the intervention period. The use of the program led to significant reductions in orders for drugs to which thepatients had reported allergies (35, vs. 146 during the preintervention period; P<0.01), excess drug dosages (87 vs. 405, P<0.01), and antibiotic-susceptibility mismatches (12 vs. 206, P<0.01). There were alsomarked reductions in the mean number of days of excessive drug dosage(2.7 vs. 5.9, P<0.002) and in adverse events caused by antiinfective agents (4 vs. 28, P<0.02). In analyses of patients who received antiinfective agents, those treated during the intervention period who always received the regimens recommended by the computer program (n=203) had significant reductions, as compared with those who did not always receive the recommended regimens (n=195) and those in the preintervention cohort (n=766), in the cost of an tiinfective agents (adjusted mean,$102 vs. $427 and $340, respectively; P<0.001), in total hospital costs (adjusted mean, $26,315 vs. $44,865 and $35,283; P<0.001), and in the length of the hospital stay (adjusted mean, 10.0 vs. 16.7 and 12.9 days; P<0.001). Conclusions A computerized antiinfectives-management program can improve the quality of patient care and reduce costs. (C) 1998, Massachusetts Medical Society.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 08:45:01