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First published April 2, 2004 as JAMIA PrePrint; doi:10.1197/jamia.M1493
Journal of the American Medical Informatics Association 2004;11(4):281-284
© 2004 American Medical Informatics Association

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Submitted on October 31, 2003
Accepted on March 15, 2004

Information Resources Used in Antimicrobial Prescribing

Jonathan S. Sellman MD1, Douglas Decarolis PharmD2, Anne Schullo-Feulner PharmD2, David B. Nelson PhD3, and Gregory A. Filice MD4*

Affiliation of the authors: 1 Medicine Service, Veterans Affairs Medical Center, Minneapolis, MN; Department of Internal Medicine, School of Medicine, University of Minnesota, Minneapolis, MN; 2 Pharmacy Service, Veterans Affairs Medical Center, Minneapolis, MN; 3 Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN; 4 Veterans Affairs Medical Center, Minneapolis, MN; Department of Internal Medicine, School of Medicine, University of Minnesota, Minneapolis, MN

* To whom correspondence should be addressed.

To describe resources clinicians use when they prescribe antimicrobials, we surveyed prescribers by telephone within hours (median 2.9) after they ordered one or more antimicrobials for a patient. Among 157 prescribers, 87 (55%) used one or more external resources to aid in decisions about their order. The other 70 (45%) used only their own knowledge and experience. Fifty-nine (38%) consulted another person. Fifty-four (34%) used a print, computer, or Internet resource. In multivariate analysis, use of an external resource was associated with the clinician being on the Medical Service (odds ratio (OR) 2.99, 95% confidence interval (CI) 1.41-6.3) or being an intern (OR 13.65, 95% CI 1.44-128). Eighty percent of providers said information about antimicrobial prescribing at the point of electronic order entry would be helpful. We concluded that decision support at the point of electronic order entry is likely to be used and might improve antimicrobial prescribing.




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