Impact of a mobile decision support tool on antimicrobial stewardship indicators in St. John's, Canada.

<h4>Objectives</h4>Inappropriate antibiotic use contributes to antimicrobial resistance. The SpectrumTM app provides antibiotic decision support, based on local antimicrobial resistance rates. We determined the impact of regional implementation of the app on inpatient antimicrobial appro...

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Autores principales:	Daniel Doyle, Gerald McDonald, Claire Pratt, Zahra Rehan, Tammy Benteau, Jennifer Phillips, Peter Daley
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/055aaf2a7fa045549878637e8a338536
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spelling	oai:doaj.org-article:055aaf2a7fa045549878637e8a3385362021-12-02T20:03:52ZImpact of a mobile decision support tool on antimicrobial stewardship indicators in St. John's, Canada.1932-620310.1371/journal.pone.0252407https://doaj.org/article/055aaf2a7fa045549878637e8a3385362021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252407https://doaj.org/toc/1932-6203<h4>Objectives</h4>Inappropriate antibiotic use contributes to antimicrobial resistance. The SpectrumTM app provides antibiotic decision support, based on local antimicrobial resistance rates. We determined the impact of regional implementation of the app on inpatient antimicrobial appropriateness, inpatient antimicrobial usage (AMU), population-based Clostridioides difficile infection (CDI) rates and cost, using a retrospective, before and after quasi-experimental design, including a one-year study period.<h4>Methods</h4>The SpectrumTM app was released to prescribers in February, 2019. We performed two one-day inpatient point prevalence surveys using the National Antimicrobial Prescribing Survey tool, six months before (June 25, 2018) and six months after (June 25, 2019) app dissemination. Inpatient AMU in Defined Daily Dose/1000 patient days and CDI incidence were compared, before and after app dissemination.<h4>Results</h4>The pre-survey included 184 prescriptions, and the post-survey included 197 prescriptions. Appropriateness was 97/176 (55.1%) pre, and 126/192 (65.6%) post (+10.5%, p = 0.051). Inpatient AMU declined by 6.6 DDD/1000 patient days per month, and CDI declined by 0.3 cases per month. Cost savings associated with reduced AMU were $403.98/bed/year and associated with reduced CDI were $82,078/year.<h4>Conclusion</h4>We observed improvement in antimicrobial stewardship indicators following SpectrumTM implementation. We cannot determine the cause of these improvements.Daniel DoyleGerald McDonaldClaire PrattZahra RehanTammy BenteauJennifer PhillipsPeter DaleyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252407 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Daniel Doyle Gerald McDonald Claire Pratt Zahra Rehan Tammy Benteau Jennifer Phillips Peter Daley Impact of a mobile decision support tool on antimicrobial stewardship indicators in St. John's, Canada.
description	<h4>Objectives</h4>Inappropriate antibiotic use contributes to antimicrobial resistance. The SpectrumTM app provides antibiotic decision support, based on local antimicrobial resistance rates. We determined the impact of regional implementation of the app on inpatient antimicrobial appropriateness, inpatient antimicrobial usage (AMU), population-based Clostridioides difficile infection (CDI) rates and cost, using a retrospective, before and after quasi-experimental design, including a one-year study period.<h4>Methods</h4>The SpectrumTM app was released to prescribers in February, 2019. We performed two one-day inpatient point prevalence surveys using the National Antimicrobial Prescribing Survey tool, six months before (June 25, 2018) and six months after (June 25, 2019) app dissemination. Inpatient AMU in Defined Daily Dose/1000 patient days and CDI incidence were compared, before and after app dissemination.<h4>Results</h4>The pre-survey included 184 prescriptions, and the post-survey included 197 prescriptions. Appropriateness was 97/176 (55.1%) pre, and 126/192 (65.6%) post (+10.5%, p = 0.051). Inpatient AMU declined by 6.6 DDD/1000 patient days per month, and CDI declined by 0.3 cases per month. Cost savings associated with reduced AMU were $403.98/bed/year and associated with reduced CDI were $82,078/year.<h4>Conclusion</h4>We observed improvement in antimicrobial stewardship indicators following SpectrumTM implementation. We cannot determine the cause of these improvements.
format	article
author	Daniel Doyle Gerald McDonald Claire Pratt Zahra Rehan Tammy Benteau Jennifer Phillips Peter Daley
author_facet	Daniel Doyle Gerald McDonald Claire Pratt Zahra Rehan Tammy Benteau Jennifer Phillips Peter Daley
author_sort	Daniel Doyle
title	Impact of a mobile decision support tool on antimicrobial stewardship indicators in St. John's, Canada.
title_short	Impact of a mobile decision support tool on antimicrobial stewardship indicators in St. John's, Canada.
title_full	Impact of a mobile decision support tool on antimicrobial stewardship indicators in St. John's, Canada.
title_fullStr	Impact of a mobile decision support tool on antimicrobial stewardship indicators in St. John's, Canada.
title_full_unstemmed	Impact of a mobile decision support tool on antimicrobial stewardship indicators in St. John's, Canada.
title_sort	impact of a mobile decision support tool on antimicrobial stewardship indicators in st. john's, canada.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/055aaf2a7fa045549878637e8a338536
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Impact of a mobile decision support tool on antimicrobial stewardship indicators in St. John's, Canada.

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