A real-world evaluation of a Case-Based Reasoning algorithm to support antimicrobial prescribing decisions in acute care

07 April 2020

A locally developed Case-Based Reasoning (CBR) algorithm, designed to augment antimicrobial prescribing in secondary care was evaluated.

Prescribing recommendations made by a CBR algorithm were compared to decisions made by physicians in clinical practice. Comparisons were examined in two patient populations. Firstly, in patients with confirmed Escherichia coli blood stream infections (‘E.coli patients’), and secondly in ward-based patients presenting with a range of potential infections (‘ward patients’). Prescribing recommendations were compared against the Antimicrobial Spectrum Index (ASI) and the WHO Essential Medicine List Access, Watch, Reserve (AWaRe) classification system. Appropriateness of a prescription was defined as the spectrum of the prescription covering the known, or most-likely organism antimicrobial sensitivity profile.

Further reading: Clinical Infectious Diseases

Author(s): Timothy M Rawson, Bernard Hernandez, Luke S P Moore, Pau Herrero, Esmita Charani, Damien Ming, Richard C Wilson, Oliver Blandy, Shiranee Sriskandan, Mark Gilchrist, Christofer Toumazou, Pantelis Georgiou, Alison H Holmes

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