Mortality Benefits of Antibiotic Computerised Decision Support System: Modifying Effects of Age.

摘要: Antibiotic computerised decision support systems (CDSSs) are shown to improve antibiotic prescribing, but evidence of beneficial patient outcomes is limited. We conducted a prospective cohort study in 1500-bed tertiary-care hospital Singapore, evaluate the effectiveness hospital's CDSS on patients' clinical outcomes, and modification these effects by factors. To account for clustering, we used multilevel logistic regression models. One-quarter 1886 eligible inpatients received CDSS-recommended antibiotics. Receipt antibiotics according CDSS's recommendations seemed halve mortality risk patients (OR 0.54, 95% CI 0.26-1.10, P = 0.09). Patients aged ≤65 years had greater benefit 0.45, 0.20-1.00, P = 0.05) than that were older 65 1.28, 0.91-1.82, P = 0.16). No effect was observed incidence Clostridium difficile 1.02, 0.34-3.01), multidrug-resistant organism 1.06, 0.42-2.71) infections. increase infection-related readmission 1.16, 0.48-2.79) found survivors. reduced or younger did not patients. Physicians should be informed benefits their acceptance recommendations.