Using Information Systems Technology to Improve Antibiotic Prescribing

  • Thomas C. Bailey
  • S. Troy McMullin
  • Janette Coble


The selection of antimicrobial agents in the hospital setting is still a largely manual task and, therefore, fraught with the potential for error. This includes the choice of agents, dosage regimens, and monitoring for response and toxicity. The authors describe current and future strategies to use information technology to improve the process of antimicrobial selection, avoid dosing errors and contraindicated drug combinations.


Adverse Drug Event Antibiotic Prescribe Clinical Pharmacist Antibiotic Selection Computerize Physician Order Entry 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    McDonald CJ. Protocol-based computer reminders, the quality of care and the nonperfectability of man. New England Journal of Medicine. 295:1351, 1976.PubMedCrossRefGoogle Scholar
  2. 2.
    Kohn L, Corrigan J, Donaldson M (eds). To err is human: building a safer health system. Committee on Quality of Health Care in America. Institute Of Medicine. Washington, D.C.; National Academy Press, 1999.Google Scholar
  3. 3.
    McMullin ST, Reichley RM, Watson LA, Steib SA, Frisse ME, Bailey TC. Experience with advanced technologies that reduce medication errors. In Proceedings, Enhancing Patient Safety and Reducing Errors in Health Care. National Patient Safety Foundation of the American Medical Association, 1999:132.Google Scholar
  4. 4.
    McMullin ST, Reichley RM, Watson LA, Steib SA, Frisse ME, Bailey TC. Impact of a Web-based clinical information system on cisapride drug interactions and patient safety. Arch Intern Med 159:2077, 1999.PubMedCrossRefGoogle Scholar
  5. 5.
    Cullen DJ, Sweitzer BJ, Bates DW, Burdick E, Edmondson A, Leape LL. Preventable adverse drug events in hospitalized patients: a comparative study of intensive care and general care units. Critical Care Medicine 25:1289, 1997.PubMedCrossRefGoogle Scholar
  6. 6.
    Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, Small SD, Sweitzer BJ, Leape LL. The costs of adverse drug events in hospitalized patients. JAMA 277:307, 1997.PubMedCrossRefGoogle Scholar
  7. 7.
    Leibovici L, Gitelman V, Yehezkelli Y, Poznanski O, Milo G, et al. Improving antibiotic empirical antibiotic treatment: prospective, nonintervention testing of a decision support system. J Intern Med 242:395, 1997.PubMedCrossRefGoogle Scholar
  8. 8.
    Kaufman D, Haas CE, Edinger R, Hollick G. Antibiotic susceptibility in the surgical intensive care unit compared with the hospital-wide antibiogram. Archives of Surgery 133:1041, 1998.PubMedCrossRefGoogle Scholar
  9. 9.
    Pestotnik SL, Classen DC, Evans RS, Burke JP. Implementing antibiotic practice guidelines through computer-assisted decision support: clinical and financial outcomes. Ann Intern Med 124:884, 1996.PubMedCrossRefGoogle Scholar
  10. 10.
    Evans RS, Pestotnik SL, Classen DC, Clemmer TP, Weaver LK, Orme JF Jr, Lloyd JF, Burke JP. A computer-assisted management program for antibiotics and other antiinfective agents. New England J Med 338:232, 1998.CrossRefGoogle Scholar
  11. 11.
    Pestotnik SL, Evans RS, Burke JP, Gardner RM, Classen DC. Therapeutic antibiotic monitoring: surveillance using a computerized expert system. American J Med 88:43, 1990.CrossRefGoogle Scholar
  12. 12.
    Ringold DJ, Santell JP, Schneider PJ, Arenberg S. ASHP national survey of pharmacy practice in acute care settings: prescribing and transcribing-1998. Am J Health-Syst Pharm 56:142, 1999.PubMedGoogle Scholar
  13. 13.
    Bates DW, Teich JM, Lee J, Seger D, Kuperman GJ, Ma’Luf N, Boyle D, Leape L. The impact of computerized physician order entry on medication error prevention. J American Med Informatics Association 6:313, 1999.CrossRefGoogle Scholar
  14. 14.
    Bates DW, Leape LL, Cullen DJ, Laird N, Petersen LA, Teich JM, Burdick E, Hickey M, Kleefield S, Shea B, Vander Vliet M, Seger DL. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA 280:1311, 1998.PubMedCrossRefGoogle Scholar
  15. 15.
    Leape LL, Cullen DJ, Dempsey Clapp M, Burdick E, Demonaco HJ et al. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA 282:267, 1999.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Thomas C. Bailey
  • S. Troy McMullin
  • Janette Coble

There are no affiliations available

Personalised recommendations