Electronic Health Records and Antimicrobial Stewardship Research: a Narrative Review

Area of Science:

• Epidemiology
• Health Informatics
• Antimicrobial Stewardship

Background:

• Electronic health records (EHRs) provide valuable data for monitoring antibiotic utilization and infection trends.
• Previous research indicates varying success in reducing antibiotic prescribing across different infection types.

Purpose of the Study:

• To review epidemiological research utilizing EHRs for antimicrobial stewardship.
• To assess the impact of EHRs on antibiotic prescribing patterns and patient outcomes.

Main Methods:

• Systematic review of epidemiological studies employing EHR data.
• Analysis of trends in antibiotic prescribing, diagnoses, and infection consultations.
• Evaluation of EHRs in interventional studies, including point-of-care and cluster randomized trials.

Main Results:

• EHRs facilitate surveillance of antibiotic use and infection consultations, with notable declines in UK respiratory tract infection prescribing.
• Improvements in drug selection and reductions in broad-spectrum antimicrobial use have been observed.
• Increased diagnoses of pneumonia, sepsis, and bacterial endocarditis in primary care suggest enhanced detection.
• Analytical studies quantify risks associated with reduced antibiotic prescribing, identifying patient groups for safer reduction.

Conclusions:

• EHRs offer significant potential for surveillance and targeted interventions to optimize antimicrobial prescribing.
• Engaging practitioners with EHR-derived insights can lead to improved prescribing practices and patient outcomes.
• Further research using targeted study designs with EHRs can refine antimicrobial stewardship strategies.