Abstract
Clinical decision support systems (CDSSs) are increasingly being used by clinicians to support antibiotic decision making in infection management. However, coexisting CDSSs often target different types of physicians, infectious situations, and patient profiles. The objective of this study was to perform an up-to-date inventory of French language CDSSs currently used in community and hospital settings for antimicrobial prescribing and to describe their main characteristics. A literature search, a search among smartphone application stores, and an open discussion with antimicrobial stewardship (AMS) experts were conducted in order to identify available French language CDSSs. Any clinical decision support tool that provides a personalized recommendation based on a clinical situation and/or a patient was included. Eleven CDSSs were identified through the search strategy. Of the 11 CDSSs, only 2 had been the subject of published studies, while 9 CDSSs were identified through smartphone application stores and expert knowledge. The majority of CDSSs were available free of charge (n = 8/11, 73%). Most CDSSs were accessible via smartphone applications (n = 9/11, 82%) and online websites (n = 8/11, 73%). Recommendations for antibiotic prescribing in urinary tract infections, upper and lower respiratory tract infections, and digestive tract infections were provided by over 90% of the CDSSs. More than 90% of the CDSSs displayed recommendations for antibiotic selection, prioritization, dosage, duration, route of administration, and alternative antibiotics in case of allergy. Information about antibiotic side effects, prescription recommendations for specific patient profiles and adaptation to local epidemiology were often missing or incomplete. There is a significant but heterogeneous offer for antibiotic prescribing decision support in French language. Standardized evaluation of these systems is needed to assess their impact on antimicrobial prescribing and antimicrobial resistance.
Highlights
Antimicrobial resistance (AMR) is a major public health concern worldwide [1,2]
Two additional clinical decision support system (CDSS) were found by the search on application stores, after excluding one CDSS intended for antibiotic prescribing in veterinary medicine
A total of 11 CDSSs were included in the inventory: Antibioclic, Antibiogarde, Antibiogilar, antibioGUIDE (Perpignan), Antibioguide (Basse-Normandie), AntibioEst, APPLIBIOTIC, ePOPI, Prescriptor, Antibiothérapie Pédiatrique, AntibioHelp®
Summary
Antimicrobial resistance (AMR) is a major public health concern worldwide [1,2]. It is associated with high morbidity and mortality as well as significant healthcare costs [2].In response to the global threat of AMR, antimicrobial stewardship programs (ASPs) have been introduced to optimize antibiotic use and to improve the quality of infection care [3,4]. Antimicrobial resistance (AMR) is a major public health concern worldwide [1,2]. It is associated with high morbidity and mortality as well as significant healthcare costs [2]. In response to the global threat of AMR, antimicrobial stewardship programs (ASPs) have been introduced to optimize antibiotic use and to improve the quality of infection care [3,4]. ASPs have been proven to be effective to tackle AMR in hospital and community settings [5,6]. ASPs based on physician education and increased availability of guidelines through decision support tools such as clinical decision support systems (CDSSs) have shown significant results in improving appropriate antibiotic prescribing [7,8]. CDSSs are computerized tools designed to support diagnostic or therapeutic decisionmaking in order to improve clinical practice and quality of care [9,10]. CDSSs provide expert or evidence-based recommendations to promote the appropriate choice of antibiotics, dosage, route of administration, and duration of treatment
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