Evidence map›Paper›PMID 41588047›Full record

ArticleNPJ digital medicine2026

Algorithmic antibiotic decision-making in urinary tract infection using prescriber-informed prediction of treatment utility.

Alex Howard, Peter L Green, Yinzheng Zhong, David M Hughes, Alessandro Gerada, Simon Maskell, Anoop Velluva, Iain E Buchan, William Hope

Abstract read
In one paragraph

Article in NPJ digital medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Alex HowardDepartment of Clinical Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, William Henry Duncan Building, University of Liverpool, Liverpool, UK. alexander.howard@liverpool.ac.uk.
Peter L GreenDepartment of Clinical Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, William Henry Duncan Building, University of Liverpool, Liverpool, UK.
Yinzheng ZhongDepartment of Clinical Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, William Henry Duncan Building, University of Liverpool, Liverpool, UK.
David M HughesDepartment of Health Data Science, Institute of Population Health, University of Liverpool, Waterhouse Building Block B, Liverpool, UK.
Alessandro GeradaDepartment of Clinical Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, William Henry Duncan Building, University of Liverpool, Liverpool, UK.
Simon MaskellDepartment of Electrical Engineering and Electronics, School of Electrical Engineering, Electronics, and Computer Science, University of Liverpool, The Quadrangle, Brownlow Hill, Liverpool, UK.
Anoop VelluvaDepartment of Clinical Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, William Henry Duncan Building, University of Liverpool, Liverpool, UK.
Iain E BuchanCivic Health Innovation Labs, University of Liverpool, Liverpool Science Park, Liverpool, UK.
William HopeDepartment of Clinical Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, William Henry Duncan Building, University of Liverpool, Liverpool, UK.

Funding

Wellcome TrustWellcome Trust 226691/Z/22/Z
6 · The paper itself

Abstract

Predicting antibiotic treatment outcomes could help tackle antibiotic resistance by guiding prescribing decisions. Existing approaches do not quantitatively incorporate the judgment of clinician users. Our antibiotic decision-making algorithm predicted treatment outcomes for 13 antibiotics using clinical prediction models trained on prescribing and urine culture data from 93,906 patients, then weighted outcomes using treatment decisions made by 49 clinicians in an antibiotic choice ranking exercise. In a simulation using Emergency Department data, the algorithm chose more correctly-targeted World Health Organization Access category antibiotics (75.6% of cases versus 11.9%, 95% confidence interval of difference 57.6% to 69.7%, p < 0.001) and oral antibiotics (69% versus 22.6%, 95% confidence interval of difference 39.5% to 53.4%, p < 0.001) than human prescribers, and fewer intravenous antibiotics (31.2% versus 65.8%, 95% confidence interval of difference -41.9% to -27.1%, p < 0.001). These results show that our algorithm could improve antibiotic prescribing decisions by combining human judgment with data-driven probability predictions.

Identifiers

PMID41588047
PMCPMC12882935

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Registered trials

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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.