Observational studyInternational journal of clinical pharmacy2015
Role of an electronic antimicrobial alert system in intensive care in dosing errors and pharmacist workload.
Observational study in International journal of clinical pharmacy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- Effectiveness of the Prospective Prescription Review System in Reducing Irrational Prescriptions at a Tertiary Specialty Hospital: Retrospective Cohort Study.JMIR formative research · 2026Article
- A Narrative Review of Clinical Decision Support for Inpatient Clinical Pharmacists.Applied clinical informatics · 2021Review
- A narrative review of the impact of interventions in acute kidney injury.Journal of nephrology · 2018Review
- Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.Drugs & aging · 2016Article
- A concise drug alerting rule set for Chinese hospitals and its application in computerized physician order entry (CPOE).SpringerPlus · 2016Article
- Impact of electronic-alerting of acute kidney injury: workgroup statements from the 15(th) ADQI Consensus Conference.Canadian journal of kidney health and disease · 2016Review
- Hospital Pharmacy in Belgium: From Moving Boxes to Providing Optimal Therapy.The Canadian journal of hospital pharmacyArticle
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCritically ill patients are vulnerable to dosing errors. We developed an electronic Antimicrobial Dose alert based upon Creatinine clearance (ADC-alert), which gives daily antimicrobial dosing advice based upon the 24-h creatinine clearance (CLcr).
objectivePrimary objective: to verify the correctness of the ADC-alert output and its benefit for the workload of the clinical pharmacist (CP). Secondary objective to compare the ADC-alert output between patients with normal and impaired CLcr.
settingThe 36-bed surgical and medical intensive care unit (ICU) of the Ghent University Hospital, Ghent, Belgium.
methodIn a single centre prospective observational 44-day study, prescriptions were reviewed by CP and compared with the ADC-alert output advice. CP workload was calculated with and without the use of the ADC-alert. Impaired renal function was defined as a CLcr < 50 mL/min for at least 1 day during antimicrobial treatment in the ICU or the need for renal replacement therapy (RRT).
main outcome measuresCorrect dosing recommendation by ADC-alert compared to CP review and time spent by CP with and without the ADC-alert.
resultsA total of 87 patients (554 daily antimicrobial prescriptions; 435 patient days) were both screened by CP and ADC-alert. Renal function impairment occurred in 39 patients (44.8 %) with 12 patients requiring RRT. The ADC-alert gave a correct dosage advice in 483 prescriptions (87.2 %). The overall sensitivity was 77.3 %; specificity was 89.9 %. Use of the ADC-alert reduces CP workload with 76.5 % (average time spent per patient: 17 vs. 4 min). Patients with a CLcr < 50 mL/min less frequently received a correct recommendation than patients with normal CLcr (P = 0.001). This was due to configuration problems in dialysis patients.
conclusionWe developed and evaluated an electronic alert system to generate dynamic antimicrobial dose adaptation based on the daily calculation of the 24-h CLcr of ICU patients. Its use led to substantial time savings for clinical pharmacists. However, the alert advice suffered from some developmental and other flaws. Despite resolving some of these shortcomings, bedside interpretation of the results and clinical judgement remain necessary.
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