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  N Engl J Med. 1998 Jan 22;338(4):232-8.A computer-assisted management program for antibiotics and other antiinfective agents.Evans RS, Pestotnik SL, Classen DC, Clemmer TP, Weaver LK, Orme JF Jr, Lloyd JF, Burke JP.SourceDepartment of Clinical Epidemiology, LDS Hospital, Salt Lake City, UT 84143, USA.AbstractBACKGROUND AND METHODS: Optimal decisions about the use of antibiotics and 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 and improve the quality of care. This program presents epidemiologic information, along with detailed recommendations and warnings. The program recommends 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 the patients 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 also marked 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 antiinfective 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 days (adjusted mean, 10.0 vs. 16.7 and 12.9; P<0.001). CONCLUSIONS; A computerized antiinfectives-management program can improve the quality of patient care and reduce costs.Comment inA computer-assisted management program for antiinfective agents. [N Engl J Med. 1998]A computer-assisted management program for antiinfective agents.Cole CL. N Engl J Med. 1998 Jun 11; 338(24):1775; author reply 1776. Computers and the quality of care--a clinician's perspective. [N Engl J Med. 1998]Computers and the quality of care--a clinician's perspective.Garibaldi RA. N Engl J Med. 1998 Jan 22; 338(4):259-60. A computer-assisted management program for antiinfective agents. [N Engl J Med. 1998]A computer-assisted management program for antiinfective agents.Johnson JR. N Engl J Med. 1998 Jun 11; 338(24):1775; author reply 1776. A computer-assisted management program for antiinfective agents. [N Engl J Med. 1998]A computer-assisted management program for antiinfective agents.Majumdar SR, Ross-Degnan D, Soumerai SB. N Engl J Med. 1998 Jun 11; 338(24):1775; author reply 1776. A computer-assisted management program for antiinfective agents. [N Engl J Med. 1998]A computer-assisted management program for antiinfective agents.Duncan RA. N Engl J Med. 1998 Jun 11; 338(24):1775-6. PMID: 9435330 [PubMed - indexed for MEDLINE] Free full textPublication Types, MeSH Terms, SubstancesPublication TypesComparative StudyResearch Support, Non-U.S. Gov'tMeSH TermsAnti-Bacterial Agents/economicsAnti-Bacterial Agents/therapeutic useAnti-Infective Agents/economicsAnti-Infective Agents/therapeutic use*Decision Support Systems, Clinical/economicsDrug Therapy, Computer-Assisted*/economicsHealth Care CostsHumansMedical Records Systems, ComputerizedOutcome and Process Assessment (Health Care)Prospective StudiesQuality of Health CareSoftwareSubstancesAnti-Bacterial AgentsAnti-Infective AgentsLinkOut - more resourcesFull Text SourcesAtypon - PDFAtyponEBSCOOvid Technologies, Inc.ProQuest
  Development and impact of a computerized pediatric antiinfective decision support program.Mullett CJ, Evans RS, Christenson JC, Dean JM. Pediatrics. 2001 Oct; 108(4):E75. Evaluation of a computer-assisted antibiotic-dose monitor.
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  A computer-assisted management program for antibiotics and other antiinfective agents.N Engl J Med. 1998 Jan 22 ;338(4):232-8.