Clinical Decision Support Systems and Their Role in Antibiotic Stewardship: a Systematic Review

  • Barry Rittmann
  • Michael P. Stevens
Healthcare Associated Infections (G Bearman and D Morgan, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Healthcare Associated Infections


Purpose of Review

The purpose of this article is to perform a systematic review over the past 5 years on the role and effectiveness of clinical decision support systems (CDSSs) on antibiotic stewardship.

Recent Findings

CDDS interventions found a significant impact on multiple outcomes relevant to antibiotic stewardship. There are various types of CDSS implementations, both active and passive (provider initiated). Passive interventions were associated with more significant outcomes; however, both interventions appeared effective. In the reviewed literature, CDSSs were consistently associated with decreasing antibiotic consumption and narrowing the spectrum of antibiotic usage. Generally, guideline adherence was improved with CDSS, although this was not universal. The effect on other outcomes, such as mortality, Clostridiodes difficile infections, length of stay, and cost, inconsistently showed a significant difference.


Overall, CDDS implementation has effectively decreased antibiotic consumption and improved guideline adherence across the various types of CDSS. Other positive outcomes were noted in certain settings, but were not universal. When creating a new intervention, it is important to identify the optimal structure and deployment of a CDSS for a specific setting.


Clinical decision support system CDDS Decision support system Antibiotic stewardship Antimicrobial stewardship 


Compliance with Ethical Standards

Conflict of Interest

Barry Rittmann and Michael Stevens declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Barry Rittmann
    • 1
    • 2
  • Michael P. Stevens
    • 1
  1. 1.Virginia Commonwealth University Health SystemsRichmondUSA
  2. 2.NorfolkUSA

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