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《Chinese Journal of Difficult and Complicated Cases》 2010-12
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Appling effect of intelligent antibiotic prescription automatic screeing system in very-elderly patients

GE Jian- li~*,ZHAI Xiao-bo,SHAO Li,et al.* Department of Gerontology,Dongfang Hospital Affiliated to Tongji University, Shanghai 200120,China  
Objective To evaluate the effects of intelligent antibiotic prescription automatic screening system on adverse drug events(ADEs) and improvement of clinical safety in very-elderly patients.Methods Elderly in-patients (80 years old) from Gerontology Departments,July,2007 to June,2009) were selected randomly.At phaseⅠ,intelligent antibiotic prescription automatic screening system was not used.At phaseⅡ,the screening system was used.According to Naranjo score sheet,ADEs would be determined.Efficiency of antibiotics;incidence,distribution, and severity of antibiotic-related ADEs;hospitalization duration,cost of preventable ADEs were compared between phaseⅠand phaseⅡ.Results(1) In very-elderly patients with normal renal function,alarm system warning was mainly because of inadequate daily frequency when using time-dependent antibiotics.However,in patients with renal insufficiency,the warning was mainly due to the usage of antibiotics over the dose or frequency.(2)The incidence of total ADEs and preventable ADEs had decreased after intervention(P0.01).The severe events accounted for a maximum of ADEs,which decreased most significantly after intervention.(3) Hospitalization duration and hospitalization costs for preventable ADEs decreased significantly(P0.01) in interventional group.Conclusion The incidence of antibiotics-related ADEs was higher in very-elderly inpatient than that in young.The use of intelligent antibiotic prescription automatic screening system would achieve more clinical benefit,including significantly shortening the hospitalization duration,lowering hospital costs,reducing medical risks.
【Fund】: 上海市科委重点科技支撑计划(No.08411951300)
【CateGory Index】: R197.324
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