Impact of clinical decision support on empirical antibiotic prescribing for children with community-acquired pneumonia
© 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: To assess the impact of a computerised clinical decision support system (CDSS) on antibiotic use in hospitalised children with a presumptive diagnosis of uncomplicated community-acquired pneumonia (CAP)....
| Main Authors: | , , , , |
|---|---|
| Format: | Journal Article |
| Published: |
Wiley-Blackwell Publishing Ltd.
2018
|
| Online Access: | http://hdl.handle.net/20.500.11937/71734 |
| _version_ | 1848762558489559040 |
|---|---|
| author | Mostaghim, M. Snelling, Thomas McMullan, B. Ewe, Y. Bajorek, B. |
| author_facet | Mostaghim, M. Snelling, Thomas McMullan, B. Ewe, Y. Bajorek, B. |
| author_sort | Mostaghim, M. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: To assess the impact of a computerised clinical decision support system (CDSS) on antibiotic use in hospitalised children with a presumptive diagnosis of uncomplicated community-acquired pneumonia (CAP). Methods: Codes associated with lower respiratory tract infection were used to identify cases of presumed uncomplicated CAP requiring admission to a tertiary paediatric hospital. Random sampling of the periods between 1 October 2010 and 30 September 2012 (pre-CDSS) and 1 October 2012 and 30 September 2014 (post-CDSS) determined the sequence of case assessment by two independent investigators. Initial antibiotic therapy, associated CDSS approvals and documented signs of clinical deterioration prior to antibiotic decision-making were recorded. Results: Statistically significant differences between cases pre- and post-CDSS implementation were minimal. High fever was observed in 57.5% (77/134) cases pre-CDSS and 45.8% (49/107) cases post-CDSS (P = 0.07). Supplemental oxygen was used in 30.6% pre-CDSS and 54.2% post-CDSS cases (P < 0.001). Narrow-spectrum penicillins were prescribed most often, with no statistically significant change post-CDSS implementation (81.3% pre-CDSS, 77.6% post-CDSS, P = 0.47). Macrolides were used consistently throughout the study period (53.7% pre-CDSS, 61.7% post-CDSS; P = 0.21). Conclusion: CDSS implementation did not reduce already low rates of broad-spectrum antibiotic use for uncomplicated CAP. |
| first_indexed | 2025-11-14T10:49:29Z |
| format | Journal Article |
| id | curtin-20.500.11937-71734 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:49:29Z |
| publishDate | 2018 |
| publisher | Wiley-Blackwell Publishing Ltd. |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-717342018-12-13T09:32:59Z Impact of clinical decision support on empirical antibiotic prescribing for children with community-acquired pneumonia Mostaghim, M. Snelling, Thomas McMullan, B. Ewe, Y. Bajorek, B. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: To assess the impact of a computerised clinical decision support system (CDSS) on antibiotic use in hospitalised children with a presumptive diagnosis of uncomplicated community-acquired pneumonia (CAP). Methods: Codes associated with lower respiratory tract infection were used to identify cases of presumed uncomplicated CAP requiring admission to a tertiary paediatric hospital. Random sampling of the periods between 1 October 2010 and 30 September 2012 (pre-CDSS) and 1 October 2012 and 30 September 2014 (post-CDSS) determined the sequence of case assessment by two independent investigators. Initial antibiotic therapy, associated CDSS approvals and documented signs of clinical deterioration prior to antibiotic decision-making were recorded. Results: Statistically significant differences between cases pre- and post-CDSS implementation were minimal. High fever was observed in 57.5% (77/134) cases pre-CDSS and 45.8% (49/107) cases post-CDSS (P = 0.07). Supplemental oxygen was used in 30.6% pre-CDSS and 54.2% post-CDSS cases (P < 0.001). Narrow-spectrum penicillins were prescribed most often, with no statistically significant change post-CDSS implementation (81.3% pre-CDSS, 77.6% post-CDSS, P = 0.47). Macrolides were used consistently throughout the study period (53.7% pre-CDSS, 61.7% post-CDSS; P = 0.21). Conclusion: CDSS implementation did not reduce already low rates of broad-spectrum antibiotic use for uncomplicated CAP. 2018 Journal Article http://hdl.handle.net/20.500.11937/71734 10.1111/jpc.14191 Wiley-Blackwell Publishing Ltd. restricted |
| spellingShingle | Mostaghim, M. Snelling, Thomas McMullan, B. Ewe, Y. Bajorek, B. Impact of clinical decision support on empirical antibiotic prescribing for children with community-acquired pneumonia |
| title | Impact of clinical decision support on empirical antibiotic prescribing for children with community-acquired pneumonia |
| title_full | Impact of clinical decision support on empirical antibiotic prescribing for children with community-acquired pneumonia |
| title_fullStr | Impact of clinical decision support on empirical antibiotic prescribing for children with community-acquired pneumonia |
| title_full_unstemmed | Impact of clinical decision support on empirical antibiotic prescribing for children with community-acquired pneumonia |
| title_short | Impact of clinical decision support on empirical antibiotic prescribing for children with community-acquired pneumonia |
| title_sort | impact of clinical decision support on empirical antibiotic prescribing for children with community-acquired pneumonia |
| url | http://hdl.handle.net/20.500.11937/71734 |