The effects of information technology interventions for optimizing antibiotic prescribing in urinary tract infections: a systematic review.

Abstract

<h4>Objectives</h4>Information technology (IT) solutions can facilitate evidence-based decision-making for antibiotic use by delivering timely information directly to clinicians at the point of care. This study aimed to evaluate the effects of IT interventions in optimizing antibiotic prescribing for urinary tract infections (UTIs).<h4>Methods</h4>A comprehensive search was performed in Medline (through PubMed), Web of Science, and Scopus databases from inception to June 2024. The study included randomized controlled trials (RCTs) and cluster randomized controlled trials (CRCTs) that investigated the effects of IT interventions on optimizing antibiotic prescribing for UTI patients. Participants were patients with UTI. IT interventions were used for improving antibiotic prescribing. Two researchers independently extracted data from studies on study characteristics, intervention details, and intended outcomes.<h4>Results</h4>Ten eligible studies (5 RCTs and 5 CRCTs) were included. Clinical decision support systems (CDSS) were the most common intervention type (50% of studies), often integrated with electronic health records (EHRs). Results showed mixed effects across patient-related, prescriber-related, and economic outcomes. While patient outcomes, typically measured as secondary endpoints, showed no statistically significant differences, prescriber-related outcomes showed more promising results. Four studies reported significant reductions in overall antibiotic prescribing rates, and two studies demonstrated significant increases in antibiotic appropriateness. Additionally, some studies showed decreased laboratory test orders and reduced emergency department visit durations. However, economic outcomes remained largely unaffected.<h4>Conclusion</h4>The review suggests that IT interventions, especially those focusing on prescriber behavior, hold significant promise for optimizing antibiotic prescribing practices in UTI management. However, further research is needed to explore their effect on patient outcomes and cost-effectiveness. The findings underscore the potential of IT interventions as valuable tools for combating antibiotic resistance in UTI treatment.<h4>Clinical trial</h4>Not applicable.