Sustained reduction in antimicrobial use and decrease in methicillin-resistant Staphylococcus aureus and Clostridium difficile infections following implementation of an electronic medical record at a tertiary-care teaching hospital
Journal of Antimicrobial Chemotherapy
Objectives: We evaluated the effect of implementation of an electronic medical record (EMR) on the use of antimicrobial agents and on the rates of infections with Clostridium difficile and methicillin-resistant Staphylococcus aureus (MRSA). Methods: This was a retrospective, observational study conducted between 1 January 2005 and 31 December 2009. Antimicrobial drug use, rates of nosocomial C. difficile infection (CDI) and MRSA infection, the number of medical charts reviewed and number of
... d and number of antimicrobial recommendations made and accepted were compared before and after implementing the EMR utilizing interrupted time-series analysis. Results: Compared with the 10 quarters prior to implementing the EMR, there was a 36.6% increase in the number of charts reviewed (P,0.0001), a 98.1% increase in the number of antimicrobial recommendations made (P,0.0001) and a 124% increase in the number of recommendations accepted (P,0.0001). There was a 28.8% decrease in the use of 41 commonly used antibacterial agents (P,0.0001). Nosocomial CDI decreased by 18.7% (P¼ 0.07) and nosocomial MRSA infections decreased by 45.2% (P,0.0001) following implementation of the EMR. Conclusions: Adoption of an EMR facilitated a significant increase in chart reviews and antimicrobial recommendations, which resulted in a sustained decrease in antimicrobial use. There were decreased nosocomial infections with MRSA and a trend towards decreasing CDIs following implementation of the EMR.