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Clin Infect Dis. 2014 Oct 15;59 Suppl 3:S122-33. doi: 10.1093/cid/ciu565.

Use of electronic health records and clinical decision support systems for antimicrobial stewardship.

Author information

Division of Infectious Diseases, Portland Veterans Affairs Medical Center, Portland, Oregon.
University of Nebraska Medical Center, Omaha.
Global Medical Affairs, Cubist Pharmaceuticals, Lexington, Massachusetts.
University of Wisconsin Hospital and Clinics, Madison.
Northwestern Memorial Hospital, Chicago, Illinois.


Electronic health records (EHRs) and clinical decision support systems (CDSSs) have the potential to enhance antimicrobial stewardship. Numerous EHRs and CDSSs are available and have the potential to enable all clinicians and antimicrobial stewardship programs (ASPs) to more efficiently review pharmacy, microbiology, and clinical data. Literature evaluating the impact of EHRs and CDSSs on patient outcomes is lacking, although EHRs with integrated CDSSs have demonstrated improvements in clinical and economic outcomes. Both technologies can be used to enhance existing ASPs and their implementation of core ASP strategies. Resolution of administrative, legal, and technical issues will enhance the acceptance and impact of these systems. EHR systems will increase in value when manufacturers include integrated ASP tools and CDSSs that do not require extensive commitment of information technology resources. Further research is needed to determine the true impact of current systems on ASP and the ultimate goal of improved patient outcomes through optimized antimicrobial use.


antimicrobial stewardship; clinical decision support system; electronic health record

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