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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Clinical decision support systems and antibiotic use.

Nada Atef Shebl¹, Bryony Dean Franklin, Nick Barber

¹Department of Practice and Policy, The School of Pharmacy, University of London, BMA House, Mezzanine Floor, Tavistock Square, London WC1H 9JP, UK. nada.shebl@pharmacy.ac.uk

Pharmacy World & Science : PWS

|April 27, 2007

Summary

Clinical decision support systems (CDSS) show promise for optimizing antibiotic use. While evidence is mixed, further research is needed to generalize findings beyond the United States.

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Application of the Intelligent High-Throughput Antimicrobial Sensitivity Testing/Phage Screening System and Lar Index of Antimicrobial Resistance

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Published on: July 21, 2023

Area of Science:

Health Informatics
Clinical Pharmacy
Evidence-Based Medicine

Background:

Clinical decision support systems (CDSS) are increasingly utilized to guide antibiotic prescribing.
Evaluating the effectiveness of CDSS in optimizing antibiotic use requires rigorous study designs.

Purpose of the Study:

To systematically review and appraise randomized controlled trials (RCTs) and 'before and after' studies on CDSS for antibiotic use.
To assess the impact of CDSS on clinical care and patient outcomes related to antibiotic prescribing.

Main Methods:

A comprehensive literature search was conducted in major databases (MEDLINE, EMBASE, IPA) up to October 2006.
Included studies were English-language RCTs and 'before and after' studies, excluding editorials, letters, and case reports.
Reference sections of retrieved articles were also searched for additional relevant studies.

Main Results:

Eleven studies (5 RCTs, 6 'before and after') met the inclusion criteria.
In RCTs, CDSS effectiveness varied, with only three studies showing significant benefits.
'Before and after' studies, primarily in secondary care, consistently reported significant benefits of computer-based CDSS.

Conclusions:

CDSS holds potential for improving antibiotic stewardship and patient outcomes.
Generalizability of findings is limited due to the predominance of studies conducted in the United States.
The choice of study design, including RCTs and 'before and after' studies, should be tailored to the specific research question and setting.