SynthesisBMJ open2025
Impact of clinical decision support software on empirical antibiotic prescribing and patient outcomes: a systematic review and meta-analysis.
Synthesis in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 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
6 citing papers in PubMed.
- Interventions to Reduce Antibiotic Prescribing in Small Animal Veterinary Practice: Evidence and Clinical Impact.Antibiotics (Basel, Switzerland) · 2026Review
- Review
- Large Language Model Recommendations for Empiric Antibiotics Versus Clinician Prescribing: A Non-Interventional Paired Retrospective Antimicrobial Stewardship Analysis.Antibiotics (Basel, Switzerland) · 2026Article
- Guideline Adherence of Perioperative Antibiotics and Surgical Site Infections in Noncardiac Surgery.JAMA network open · 2026Article
- Better, not just fewer: Rethinking antibiotic prescribing.PLoS medicine · 2026Article
- An Integrative Review of Automation Integration in Emergency Nursing Practice: Evidence Synthesis and Contextual Application to Rafidia Governmental Hospital, Palestine.Journal of nursing management · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo identify Clinical Decision Support Software (CDSS) that have been implemented in hospital which aim to influence empirical antibiotic prescribing, and to establish their impact on antibiotic prescribing and patient outcomes.
designSystematic review & meta-analysis. DATA SOURCES: MEDLINE, Cochrane Central Register of Controlled Trials and Embase were searched from their inception to February 2024. ELIGIBILITY CRITERIA: Studies evaluating the impact of digital CDSS with the primary purpose of influencing initial empirical antibiotic prescribing for patients with acute infection in hospital. DATA EXTRACTION AND SYNTHESIS: Study characteristics, intervention characteristics and outcome data were extracted independently by two reviewers. Outcomes were grouped into four domains including clinical outcomes (mortality, length of stay, readmission rates), antibiotic appropriateness (guideline adherence, coverage of causative organism), antimicrobial stewardship and health economics. Risk of bias assessment was conducted using Risk of Bias In Non-randomised Studies - of Interventions for non-randomised studies and Cochrane Risk of Bias 2 for randomised studies. Outcome data with sufficient reporting and homogeneity were synthesised quantitatively using a random-effects meta-analysis; other outcomes were synthesised qualitatively.
results15 full texts met the eligibility criteria after screening 7984 unique studies. Low-quality evidence suggested that implementation of CDSS was associated with lower mortality (OR 0.76, 95% CI 0.57 to 1.01) and improved adherence to antibiotic prescribing guidelines (OR 1.75, 95% CI 1.26 to 2.43). No change in length of stay or readmission rates were observed. Coverage of the causative organism was similar after CDSS implementation (OR 1.26, 95% CI 0.97 to 1.63). High-quality evidence supported the association between CDSS implementation and reduced broad-spectrum antibiotic prescribing.
conclusionsCDSS can be used to reduce the unnecessary prescribing of broad-spectrum antibiotics. Further high-quality studies are required to establish whether their implementation also results in improvements in other outcomes. PROSPERO REGISTRATION NUMBER: CRD42024501185.
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