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Computer-Assisted Antimicrobial Recommendations for Optimal Therapy: Analysis of Prescribing Errors in an Antimicrobial Stewardship Trial

  • David N. Schwartz (a1) (a2), Kevin W. McConeghy (a3), Rosie D. Lyles (a4), Ulysses Wu (a5), Robert C. Glowacki (a6) (a7), Gail S. Itokazu (a6) (a7), Piotr Kieszkowski (a3), Yingxu Xiang (a3), Bala Hota (a7) and Robert A. Weinstein (a1) (a2)...


Clinician education and prospective audit and feedback interventions, deployed separately and concurrently, did not reduce antimicrobial use errors or rates compared to a control group of general medicine inpatients at our public hospital. Additional research is needed to define the optimal scope and intensity of hospital antimicrobial stewardship interventions.

Infect Control Hosp Epidemiol 2017;38:857–859


Corresponding author

Address correspondence to David N. Schwartz, MD, Chair, Division of Infectious Diseases, John H. Stroger, Jr Hospital of Cook County, 1900 W. Polk St, Room 1236, Chicago, IL 60612 (


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PREVIOUS PRESENTATION. These data were presented in part at the 16th Annual Meeting of the Society for Healthcare Epidemiology of America, Chicago, Illinois, March 16–21, 2006, (abstracts 27 and 317), and at the 17th Annual Meeting of the Society for Healthcare Epidemiology of America, Baltimore, MD, April 14–17, 2007 (abstracts 27 and 298).



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1. Barlam, TF, Cosgrove, SE, Abbo, LM, et al. Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis 2016;62:e51e77.
2. Schwartz, DN, Abiad, H, DeMarais, PL, Armeanu, E, Trick, WE, Wang, Y, Weinstein, RA. An educational intervention to improve antimicrobial use in a hospital-based long-term care facility. J Am Geriatr Soc 2007;55:12361242.
3. Schackow, TE, Chavez, M, Loya, L, et al. Audience response system: effect on learning in family medicine residents. Fam Med 2004;36:496504.
4. Schwartz, DN, Wu, US, Lyles, RD, Xiang, Y, Kieszkowski, P, Hota, B, Weinstein, RA. Lost in translation? Reliability of assessing inpatient antimicrobial appropriateness using computerized case vignettes. Infect Control Hosp Epidemiol 2009;30:163171.
5. Wisniewski, MF, Kieszkowski, P, Zagorski, BM, Trick, WE, Sommers, M, Weinstein, RA. Development of a clinical data warehouse for hospital infection control. J Am Med Inform Assoc 2003;10:454462.
6. Tickoo, S, Bhardwaj, A, Gonarow, GC, Liang, L, Bhatt, DL, Cannon, CP. Relation between hospital length of stay and quality of care in patients with acute coronary syndromes (from the American Heart Association’s Get with the Guidelines—coronary artery disease data set). Am J Cardiol 2016;117:201205.
7. Parekh, V, Saint, S, Furney, S, Kaufman, S, McMahon, L. What effect does inpatient physician specialty and experience have on clinical outcomes and resource utilization on a general medical service? J Gen Intern Med 2004;19:395401.
8. Pollack, LA, van Santen, KL, Weiner, LM, Dudeck, MA, Edwards, JR, Srinivasan, A. Antibiotic stewardship programs in US acute-care hospitals: findings from the 2014 National Healthcare Safety Network annual hospital survey. Clin Infect Dis 2016;63:443449.
9. Schwartz, DN. Antimicrobial stewardship in US hospitals: Is the cup half-full yet? Clin Infect Dis 2016;63:450453.
10. Popovski, Z, Mercuri, M, Main, C, et al. Multifaceted intervention to optimize antibiotic use for intra-abdominal infections. J Antimicrob Chemother 2015;70:12261229.
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Table S1

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