Web-based Tool Reduces Excessive Use of Antibiotics in Hospitalized Patients

Doctors who use a novel Web-based tool to prescribe special categories of antibiotics to their hospitalized patients are getting the job done faster and more safely than by traditional means of phone, fax and pager, research led by the Johns Hopkins Children's Center shows.

The online approval system reduced unnecessary antibiotics, made ordering faster and saved costs, researchers write in the Sept. 15 issue of Clinical Infectious Diseases.

Between one-third and a half of all hospital patients receive antimicrobial drugs, such as antibiotics, antifungal and antiviral medications but up to half of these prescriptions are unnecessary, researchers estimate, fueling an already serious bacterial drug resistance problem. To address the problem, Hopkins and other hospitals, have put more than 30 antimicrobial drugs on a "restricted" list, requiring approval by an infectious disease specialist before the pharmacy can dispense them to a patient. The online antibiotic approval tool, designed by and used at Hopkins Children's since June 1, 2005, involves requesting restricted antibiotics via a computer, which then automatically alerts infectious disease physicians to review a pending request. Approvals and denials are then immediately sent from the online tool via pager to both the prescriber and the pharmacy. Under the old system, the doctor would either call or page an infectious disease specialist who would then verbally approve or deny a request and call the pharmacy to notify them of any approval. The new system not only offers a digital trail or requests denied and approved, but it has sped up the approval/denial process of restricted antibiotics, reduced the number of missed and unnecessary doses, while also helping slash the cost of antimicrobial drugs by more than $370,000 in the first year of its use alone, researchers found.