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Leveraging Antimicrobial Stewardship: Focus on Individual Prescriptions Appropriateness

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Health and Social Care Systems of the Future: Demographic Changes, Digital Age and Human Factors (HEPS 2019)

Part of the book series: Advances in Intelligent Systems and Computing ((AISC,volume 1012))

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Abstract

Antimicrobial resistance and healthcare associated infections are major worldwide Public Health and Patient Safety challenges. Inappropriate antibiotic prescription is the major drive for antibiotic resistance and is present in 30 to 50% of all antibiotic prescriptions. However, adherence to guidelines and to computerized decision support systems is still poor, reflecting the complexity of the prescription process. Antimicrobial stewardship programs have been implemented aiming optimization of prescriptions. Assessment of individual prescriptions appropriateness is a major task and a pillar of these programs. Adoption of universal definitions of appropriateness and assessments, based on quality indicators, metrics and algorithms, is needed in order to improve classifications of individual prescriptions and its determinants, where new eHealth tools and ultimately artificial intelligence will be major allies. This text highlights the importance of evaluation of individual prescriptions as the major way to understand the determinants of (in)appropriate antibiotic prescription and the need for future developments. It mainly results from a comprehensive review of papers published since 2010, related to antimicrobial resistance, the prescription process, antimicrobial stewardship, as well the appropriateness of antibiotic prescription and its evaluation. The road is ahead!

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Author information

Authors and Affiliations

  1. NOVA National Public Health School, Av. Padre Cruz, 1600-560, Lisbon, Portugal

    Carlos Palos & Paulo Sousa

  2. Hospital Beatriz Ângelo, Loures, Portugal

    Carlos Palos

  3. CISP – Centro de Investigação em Saúde Pública, ENSP – Universidade Nova de Lisboa, ‎Lisbon, Portugal

    Paulo Sousa

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  1. Carlos Palos
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  2. Paulo Sousa
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Corresponding author

Correspondence to Carlos Palos .

Editor information

Editors and Affiliations

  1. Faculdade de Motricidade Humana, Laboratório de Ergonomia, CIAUD, Universidade de Lisboa, Lisbon, Portugal

    Teresa Patrone Cotrim

  2. Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal

    Florentino Serranheira

  3. Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal

    Paulo Sousa

  4. Loughborough Design School, Loughborough University, Loughborough, UK

    Sue Hignett

  5. Centre for Patient Safety, Tuscany, Italy

    Sara Albolino

  6. Careggi University Hospital, Clinical Risk Management and Patient Safety Center, Tuscany, Italy

    Riccardo Tartaglia

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Palos, C., Sousa, P. (2019). Leveraging Antimicrobial Stewardship: Focus on Individual Prescriptions Appropriateness. In: Cotrim, T., Serranheira, F., Sousa, P., Hignett, S., Albolino, S., Tartaglia, R. (eds) Health and Social Care Systems of the Future: Demographic Changes, Digital Age and Human Factors. HEPS 2019. Advances in Intelligent Systems and Computing, vol 1012. Springer, Cham. https://doi.org/10.1007/978-3-030-24067-7_15

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