CDSS for antibiotic prescriptions
The second intervention was the introduction of the CDSS for
antibiotic prescription, which was named the Samsung Antibiotic
Prescription System (SAPS), into the pre-existing CPOE in May
2008. Antimicrobial prescription for inpatients became possible
only through the CDSS in all clinical departments (Fig 1). In the
system, the first step is to select either empirical, prophylactic, or
definitive use of antibiotics. When empirical is selected, the physician
is asked to choose a presumed focus of infection. Then the
CDSS shows a list of possible etiologic microorganisms for the
selected infection and provides recommendations for empirical
antimicrobials. On choosing antimicrobials, an adjusted dosage issuggested according to the estimated creatinine clearance, calculated
automatically based on clinical information. On the selection
of definitive, the CDSS displays a list of culture reports and the
results of the identification and antimicrobial susceptibility test.
Among the susceptible antimicrobials, preferred agents with a
narrow spectrum of antibacterial activity are listed at the top for
easier selection by the physicians. For prophylactic use, a physician
is asked to choose the name of the operation among the list
of surgical procedures