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Infect Control Hosp Epidemiol. 2012 Apr;33(4):381-8. doi: 10.1086/664768.

Demonstration of the weighted-incidence syndromic combination antibiogram: an empiric prescribing decision aid.

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Department of Biomedical Informatics, Ohio State University, Columbus, Ohio, USA.



Healthcare providers need a better empiric antibiotic prescribing aid than the traditional antibiogram, which supplies no information on the relative frequency of organisms recovered in a given infection and which is uninformative in situations where multiple antimicrobials are used or multiple organisms are anticipated. We aimed to develop and demonstrate a novel empiric prescribing decision aid.


This is a demonstration involving more than 9,000 unique encounters for abdominal-biliary infection (ABI) and urinary tract infection (UTI) to a large healthcare system with a fully integrated electronic health record (EHR).


We developed a novel method of displaying microbiology data called the weighted-incidence syndromic combination antibiogram (WISCA) for 2 clinical syndromes, ABI and UTI. The WISCA combines simple diagnosis and microbiology data from the EHR to (1) classify patients by syndrome and (2) determine, for each patient with a given syndrome, whether a given regimen (1 or more agents) would have covered all the organisms recovered for their infection. This allows data to be presented such that clinicians can see the probability that a particular regimen will cover a particular infection rather than the probability that a single drug will cover a single organism.


There were 997 encounters for ABI and 8,232 for UTI. A WISCA was created for each syndrome and compared with a traditional antibiogram for the same period.


Novel approaches to data compilation and display can overcome limitations to the utility of the traditional antibiogram in helping providers choose empiric antibiotics.

[Indexed for MEDLINE]

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