Research Article

Implementation of a Computerized Decision Support System to Improve the Appropriateness of Antibiotic Therapy Using Local Microbiologic Data

Table 2

Distribution of the antibiotics administered to the 173 patients receiving empiric treatment of the antibiotics recommended by PMRTR (362 recommendations) and of the antibiotics administered to the 87 patients whose treatment was modified after PMRTR emission.

Antibiotic Patients who received empirical treatment (173 patients) Antibiotic recommended by PMRTR (362 recommendations) Treatment modified after PMRTR emission (87 patients)
Empirical treatment according to clinical criteria
(129 patients)
Empirical treatment according to LRM
(44 patients)
When Gram-negative bacillus was isolatedWhen Gram-positive cocci in clusters were isolatedWhen Gram-positive cocci in chains were isolatedTreatment modified according to clinical criteria but not PMRTR
(19 patients)
Treatment modified according to PMRTR
(68 patients)

Amoxicillin-clavulanic acid52 (22.3%)1 (1.0%)2 (0.8%)3 (7.9%)1 (0.8%)
Piperacillin-tazobactam6 (2.6%)15 (15.6%)61 (23.6%)17 (12.9%)
Cefazolin7 (3.0%)2 (2.1%)1 (2.6%)
Ceftriaxone24 (10.4%)2 (2.1%)2 (0.8%)6 (15.8%)3 (2.3%)
Cefotaxime8 (3.4%)1 (1.0%)13 (5.0%)7 (15.6%)1 (2.6%)7 (5.3%)
Ceftazidime5 (2.1%)1 (1.0%)5 (1.9%)2 (5.3%)3 (2.3%)
Cefepime1 (0.4%)1 (1.0%)13 (5.0%)2 (1.5%)
Imipenem10 (4.3%)7 (7.3%)68 (26.4%)8 (17.8%)2 (5.3%)14 (10.6%)
Meropenem15 (6.4%)12 (12.6%)7 (2.7%)3 (7.9%)16 (12.1%)
Levofloxacin25 (10.7%)5 (5.2%)20 (7.8%)10 (22.2%)2 (5.3%)7 (5.3%)
Ciprofloxacin3 (1.3%)1 (0.4%)
Amikacin14 (6.0%)15 (15.6%)61 (23.6%)3 (7.9%)26 (19.6%)
Tobramycin12 (5.2%)5 (5.2%)2 (0.8%)6 (15.8%)3 (2.3%)
Gentamicin2 (0.9%)2 (5.3%)
Vancomycin28 (12.0%)18 (18.8%)27 (45.8%)10 (22.2%)4 (10.4%)23 (17.4%)
Linezolid10 (4.3%)6 (6.3%)28 (47.5%)2 (4.4%)2 (5.3%)10 (7.6%)
Other11 (4.7%)5 (5.2%)3 (1.2%)4 (6.7%)8 (17.8%)1 (2.6%)
Total233 (100%)96 (100%)258 (100%)59 (100%)45 (100%)38 (100%)132 (100%)

LRM: local resistance map; PMRTR: preliminary microbiological reports with therapeutic recommendation.