Improving Antimicrobial Prescriptions with Computerized Decision Support Systems: Where Are We?

Antimicrobial computerized decision support systems (CDSS) have been developed to improve decision-making at the point of prescribing. Uptake of CDSS for antibiotic prescribing remains low, and evidence to suggest that CDSS provides a clear benefit for antimicrobial outcomes is scarce. We reviewed existing evidence on the impact of CDSS on antimicrobial prescribing. Based on the results of our literature search, we discuss the use of CDSS for antimicrobial management in hospitals and antibiotic prescribing practices in ambulatory primary care settings. We identify some of the issues surrounding selecting and defining appropriate outcome measures for assessing the impact of CDSS on antimicrobial prescribing in the hospital setting. In the primary care setting, we observed that CDSS has a modest impact in changing antibiotic prescribing practice, which could be related to the underutilization of antimicrobial CDSS.