Evidence map›Paper›PMID 34930162›Full record

ArticleBMC infectious diseases2021

Impact of an electronic alert on prescription patterns of meropenem, voriconazole and caspofungin.

Lionel Chok, Katharina Kusejko, Nadia Eberhard, Sandra E Chaudron, Dirk Saleschus, Claudine Kocher, Roger D Kouyos, Rainer Weber, Stefan P Kuster

Open access · goldAbstract read
In one paragraph

Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.1field-weighted citation impact, top 45% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Gram-negative bloodstream infections: where can we do better? A retrospective cohort study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Lionel Chok *Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Rämistrasse 100, Zurich, Switzerland. lionel.chok@bluewin.ch.
Katharina Kusejko *Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Rämistrasse 100, Zurich, Switzerland.
Nadia EberhardDivision of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Rämistrasse 100, Zurich, Switzerland.
Sandra E ChaudronDivision of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Rämistrasse 100, Zurich, Switzerland.
Dirk SaleschusDivision of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Rämistrasse 100, Zurich, Switzerland.
Claudine KocherDivision of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Rämistrasse 100, Zurich, Switzerland.
Roger D Kouyos *Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Rämistrasse 100, Zurich, Switzerland.
Rainer Weber *Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Rämistrasse 100, Zurich, Switzerland.
Stefan P Kuster *Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Rämistrasse 100, Zurich, Switzerland.
University Hospital of Zurich · CHUniversity of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntimicrobial stewardship programs promote the appropriate use of antimicrobial substances through the implementation of evidence-based, active and passive interventions. We analyzed the effect of a computer-assisted intervention on antimicrobial use in a tertiary care hospital.

methodsBetween 2011 and 2016 we introduced an electronic alert for patients being prescribed meropenem, voriconazole and caspofungin. At prescription and at day 3 of treatment, physicians were informed about the risk related to these antimicrobial substances by an electronic alert in the medical records. Physicians were invited to revoke or confirm the prescription and to contact the infectious disease (ID) team. Using interrupted time series regression, the days of therapy (DOTs) and the number of prescriptions before and after the intervention were compared.

resultsWe counted 64,281 DOTs for 5549 prescriptions during 4100 hospital stays. Overall, the DOTs decreased continuously over time. An additional benefit of the alert could not be observed. Similarly, the number of prescriptions decreased over time, without significant effect of the intervention. When considering the three drugs separately, the alert impacted the duration (change in slope of DOTs/1000 bed days; P = 0.0017) as well as the number of prescriptions (change in slope of prescriptions/1000 bed days; P < 0.001) of voriconazole only.

conclusionsThe introduction of the alert lowered prescriptions of voriconazole only. Thus, self-stewardship alone seems to have a limited impact on electronic prescriptions of anti-infective substances. Additional measures such as face-to-face prompting with ID physicians or audit and feedback are indispensable to optimize antimicrobial use.

Indexed as

Electronic PrescribingMedical Order Entry SystemsCaspofunginHumansMeropenemVoriconazoleCaspofunginMeropenemVoriconazoleAntibiotic consumptionAntimicrobial consumptionAntimicrobial prescriptionsAntimicrobial stewardshipElectronic alertSelf-stewardship

Identifiers

PMID34930162
PMCPMC8686259
OpenAlexW4200418390

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.