[Computerized support to improve antimicrobial prescribing: myth or reality?]

Antimicrobial stewardship programmes aim to improve antimicrobial prescribing with the final aim to improve patient care, while limiting the emergence and spread of resistant bacteria. Two main categories of digital tools are currently available in this area: stand-alone mobile applications and tools directly integrated into electronic health records. The former are easy to implement and less costly, but offer limited support as they do not take into account individual patient data. Their impact depends on the clinician's willingness to use them regularly. Integrated systems are based on more sophisticated, individualised algorithms and offer the possibility of intervening with a variety of techniques (restriction, reassessment, feedback, alerts), sometimes before the prescription occurs. They are costly and complex to implement and require an appropriate IT infrastructure. Both systems, as in other areas of digital medicine, have a low level of evidence regarding their clinical impact. In this review we examine the two types of tools, the benefits and challenges associated with each, and the available data on effectiveness.