ArticleAntimicrobial resistance and infection control2021
A mandatory indication-registration tool in hospital electronic medical records enabling systematic evaluation and benchmarking of the quality of antimicrobial use: a feasibility study.
Article in Antimicrobial resistance and infection control, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 19 citations in OpenAlex.
- The Role of Electronic Medical Record Systems and Pharmacovigilance Databases in the Surveillance of Antimicrobial Use and Resistance in Low- and Middle-Income Countries: Protocol for a Multistudy Project.JMIR research protocols · 2026Article
- Factors associated with antimicrobial drug prescription in inpatient dogs and cats at a veterinary teaching hospital.Journal of veterinary internal medicine · 2026Article
- Documentation of antimicrobial indication and duration in electronic health records in a rehabilitation hospital: a cross-sectional study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Identifying excessive length of antibiotic treatment duration for hospital-acquired infections: a semi-automated approach to support antimicrobial stewardship.Antimicrobial resistance and infection control · 2024Article
- Electronic health record-based identification of inpatients receiving antibiotic treatment for community-acquired pneumonia.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Biomedical Big Data Technologies, Applications, and Challenges for Precision Medicine: A Review.Global challenges (Hoboken, NJ) · 2024Review
- Use of Epic Electronic Health Record System for Health Care Research: Scoping Review.Journal of medical Internet research · 2023Article
- Assessing the conversion of electronic medical record data into antibiotic stewardship indicators.The Journal of antimicrobial chemotherapy · 2023Observational
- The Challenge of Overcoming Antibiotic Resistance in Carbapenem-Resistant Gram-Negative Bacteria: "Attack on Titan".Microorganisms · 2023Review
- Rapid Decrease in Fluoroquinolones Consumption following Implementation of a Simple Antimicrobial Stewardship Bundled Intervention in a University Hospital during the COVID-19 Pandemic.Antibiotics (Basel, Switzerland) · 2023Article
- Evaluation of the accuracy of a mandatory indication field for outpatient antibiotic prescriptions.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Detecting inappropriate total duration of antimicrobial therapy using semi-automated surveillance.Antimicrobial resistance and infection control · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesEvaluation of the extent and appropriateness of antimicrobial use is a cornerstone of antibiotic stewardship programs, but it is time-consuming. Documentation of the indication at the moment of prescription might be more time-efficient. We investigated the real-life feasibility of mandatory documentation of the indication for all hospital antibiotic prescriptions for quality evaluation purposes.
methodsA mandatory prescription-indication format was implemented in the Electronic Medical Record (EMR) of three hospitals using EPIC or ChipSoft HIX software. We evaluated the retrieved data of all antibiotics (J01) prescribed as empiric therapy in adult patients with respiratory tract infections (RTI) or urinary tract infections (UTI), from January through December 2017 in Hospital A, June through October 2019 in Hospital B and May 2019 through June 2020 in Hospital C. Endpoints were the accuracy of the data, defined as agreement between selected indication for the prescription and the documented indication in the EMR, as assessed by manually screening a representative sample of eligible patient records in the EMR of the three hospitals, and appropriateness of the prescriptions, defined as the prescriptions being in accordance with the national guidelines.
resultsThe datasets of hospitals A, B and C contained 9588, 338 and 5816 empiric antibiotic prescriptions indicated for RTI or UTI, respectively. The selected indication was in accordance with the documented indication in 96.7% (error rate: 10/300), 78.2% (error rate: 53/243), and 86.9% (error rate: 39/298), respectively. A considerable variation in guideline adherence was seen between the hospitals for severe community acquired pneumonia (adherence rate ranged from 35.4 to 53.0%), complicated UTI (40.0-67.1%) and cystitis (5.6-45.3%).
conclusionsAfter local validation of the datasets to verify and optimize accuracy of the data, mandatory documentation of the indication for antibiotics enables a reliable and time-efficient method for systematic registration of the extent and appropriateness of empiric antimicrobial use, which might enable benchmarking both in-hospital and between hospitals.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.