UNASSIGNED: EHRs enable surveillance of antibiotic utilisation and infection consultations. Prescribing for respiratory tract infections has declined in the UK following reduced consultation rates. Reductions in prescribing for skin and urinary tract infections have been less marked. Drug selection has improved and use of broad-spectrum antimicrobics reduced. Diagnoses of pneumonia, sepsis and bacterial endocarditis have increased in primary care. Analytical studies have quantified risks of serious bacterial infections following reduced antibiotic prescribing. EHRs are increasingly used in interventional studies including point-of-care trials and cluster randomised trials of quality improvement. Analytical and interventional studies indicate patient groups for whom antibiotic utilisation may be more safely reduced.
UNASSIGNED: EHRs offer opportunities for surveillance and interventions that engage practitioners in the effects of improved prescribing practices, with the potential for better outcomes with targeted study designs.
■EHR能够监测抗生素使用和感染咨询。随着咨询率的降低,英国的呼吸道感染处方有所下降。减少皮肤和尿路感染的处方没有那么明显。改进了药物选择,减少了广谱抗微生物剂的使用。肺炎的诊断,脓毒症和细菌性心内膜炎在初级保健中有所增加。分析研究已经量化了减少抗生素处方后严重细菌感染的风险。EHR越来越多地用于介入研究,包括即时护理试验和质量改善的集群随机试验。分析和干预研究表明,可以更安全地减少抗生素使用的患者群体。
■EHR为监督和干预提供了机会,使从业者参与改善处方实践的效果。有针对性的研究设计有可能获得更好的结果。