Rezel-Potts Emma, Gulliford Martin
School of Life Course & Population Sciences, King's College London, Guy's Campus, SE1 1UL London, UK.
NIHR Biomedical Research Centre at Guy's and St Thomas' Hospitals London, Great Maze Pond, London, SE1 9RT UK.
Curr Epidemiol Rep. 2022 Jul 21:1-10. doi: 10.1007/s40471-021-00278-1.
This review summarises epidemiological research using electronic health records (EHR) for antimicrobial stewardship.
EHRs enable surveillance of antibiotic utilisation and infection consultations. Prescribing for respiratory tract infections has declined in the UK following reduced consultation rates. Reductions in prescribing for skin and urinary tract infections have been less marked. Drug selection has improved and use of broad-spectrum antimicrobics reduced. Diagnoses of pneumonia, sepsis and bacterial endocarditis have increased in primary care. Analytical studies have quantified risks of serious bacterial infections following reduced antibiotic prescribing. EHRs are increasingly used in interventional studies including point-of-care trials and cluster randomised trials of quality improvement. Analytical and interventional studies indicate patient groups for whom antibiotic utilisation may be more safely reduced.
EHRs offer opportunities for surveillance and interventions that engage practitioners in the effects of improved prescribing practices, with the potential for better outcomes with targeted study designs.
本综述总结了利用电子健康记录（EHR）进行抗菌药物管理的流行病学研究。
电子健康记录有助于监测抗生素使用情况和感染会诊情况。在英国，随着会诊率降低，呼吸道感染的处方量有所下降。皮肤和尿路感染的处方量下降幅度较小。药物选择有所改善，广谱抗菌药物的使用减少。初级保健中肺炎、败血症和细菌性心内膜炎的诊断有所增加。分析性研究已经量化了减少抗生素处方后严重细菌感染的风险。电子健康记录越来越多地用于干预性研究，包括即时护理试验和质量改进的整群随机试验。分析性和干预性研究表明了哪些患者群体可以更安全地减少抗生素使用。
电子健康记录为监测和干预提供了机会，使从业者能够参与到改善处方实践的效果中，通过有针对性的研究设计有可能取得更好的结果。
