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 isolated
When Gram-positive cocci in clusters were isolated
When Gram-positive cocci in chains were isolated
Treatment modified according to clinical criteria but not PMRTR (19 patients)
Treatment modified according to PMRTR (68 patients)
Amoxicillin-clavulanic acid
52 (22.3%)
1 (1.0%)
2 (0.8%)
—
—
3 (7.9%)
1 (0.8%)
Piperacillin-tazobactam
6 (2.6%)
15 (15.6%)
61 (23.6%)
—
—
—
17 (12.9%)
Cefazolin
7 (3.0%)
2 (2.1%)
—
—
—
1 (2.6%)
—
Ceftriaxone
24 (10.4%)
2 (2.1%)
2 (0.8%)
—
—
6 (15.8%)
3 (2.3%)
Cefotaxime
8 (3.4%)
1 (1.0%)
13 (5.0%)
—
7 (15.6%)
1 (2.6%)
7 (5.3%)
Ceftazidime
5 (2.1%)
1 (1.0%)
5 (1.9%)
—
—
2 (5.3%)
3 (2.3%)
Cefepime
1 (0.4%)
1 (1.0%)
13 (5.0%)
—
—
—
2 (1.5%)
Imipenem
10 (4.3%)
7 (7.3%)
68 (26.4%)
—
8 (17.8%)
2 (5.3%)
14 (10.6%)
Meropenem
15 (6.4%)
12 (12.6%)
7 (2.7%)
—
—
3 (7.9%)
16 (12.1%)
Levofloxacin
25 (10.7%)
5 (5.2%)
20 (7.8%)
—
10 (22.2%)
2 (5.3%)
7 (5.3%)
Ciprofloxacin
3 (1.3%)
—
1 (0.4%)
—
—
—
—
Amikacin
14 (6.0%)
15 (15.6%)
61 (23.6%)
—
—
3 (7.9%)
26 (19.6%)
Tobramycin
12 (5.2%)
5 (5.2%)
2 (0.8%)
—
—
6 (15.8%)
3 (2.3%)
Gentamicin
2 (0.9%)
—
—
—
—
2 (5.3%)
—
Vancomycin
28 (12.0%)
18 (18.8%)
—
27 (45.8%)
10 (22.2%)
4 (10.4%)
23 (17.4%)
Linezolid
10 (4.3%)
6 (6.3%)
—
28 (47.5%)
2 (4.4%)
2 (5.3%)
10 (7.6%)
Other
11 (4.7%)
5 (5.2%)
3 (1.2%)
4 (6.7%)
8 (17.8%)
1 (2.6%)
—
Total
233 (100%)
96 (100%)
258 (100%)
59 (100%)
45 (100%)
38 (100%)
132 (100%)
LRM: local resistance map; PMRTR: preliminary microbiological reports with therapeutic recommendation.