Impact of an electronic antibiotic advice and approval system on antibiotic prescribing in an Australian teaching hospital

The impact of a computer‐based infectious diseases electronic antibiotic advice and approval system (“IDEA3S”) was assessed as an alternative to a labour‐intensive, phone‐based approval system. IDEA3S‐based approvals replaced 48% of all approvals for the most frequently requested antimicrobial agents (ceftriaxone/cefotaxime, vancomycin) and were associated with stable overall rates of antimicrobial use. Antibiotic prescribing for community‐acquired pneumonia was 76% concordant with IDEA3S recommendations, and clinical acceptance of IDEA3S was excellent. Successful implementation required a coordinated, evidence‐based approach between clinicians, pharmacists and hospital administration, together with ongoing staff education and feedback of results. IDEA3S is a useful new adjunct to routine clinician consultation to support appropriate antibiotic prescribing for a number of common indications in hospitals.