Impact of a computerized decision support system on compliance with guidelines on antibiotics prescribed for urinary tract infections in emergency departments: a multicentre prospective before-and-after controlled interventional study

• DOI: 10.1093/jac/dku191
• Publication Date: 2014-06-05T05:23:23Z
• Authors: Elisa Demonchy; Jean-Charles Dufour; Jean Gaudart; Emmanuel Cervetti; Pierre Michelet; Nicolas Poussard; Jacques Levraut; Céline Pulcini
• Keywords: Medical record

Urinary tract infections (UTIs) are one of the leading reasons for antibiotic prescriptions in emergency departments (EDs), with half these antibiotics being inappropriately prescribed. Our objective was to assess impact a computerized decision support system (CDSS) on compliance guidelines empirical (antibiotic and duration) UTIs EDs.A multicentre prospective before-and-after controlled interventional study conducted from 19 March 28 October 2012. All adults diagnosed community-acquired (cystitis, pyelonephritis or prostatitis) at three French EDs were included. The therapy considered compliant if duration prescribed accordance national guidelines. Data collected using electronic medical records. Paired tests used when comparing periods within each ED global analyses multivariate logistic mixed models.Nine hundred twelve patients included during 30 week period. CDSS 59% cases (182/307). intervention improved only bivariate analysis (absolute increase +20%, P = 0.007). choice but [OR 1.94 (95% CI 1.13-3.32)]. also changed initial diagnosis 23% cases, all EDs.The partially UTIs.