Reduction of broad-spectrum antibiotic use with computerized decision support in an intensive care unit

Abstract

Objective. To implement and evaluate the effect of a computerized decision support tool on antibiotic use in an intensive care unit (ICU). Design. Prospective before-and-after cohort study. Setting. Twenty-four bed tertiary hospital adult medical/surgical ICU. Participants. All consecutive patients from May 2001 to November 2001 (N = 524) and March 2002 to September 2002 (N = 536). Intervention. A real-time microbiology browser and computerized decision support system for isolate directed antibiotic prescription. Main outcome measures. Number of courses of antibiotic prescribed, antibiotic utilization (defined daily doses (DDDs)/100 ICU bed-days), antibiotic susceptibility mismatches, and sy..