Innovative Implementation of Antibiotic Stewardship supported by a Clinical Decision System

L. Velez-Lapao, Mélanie R. Maia, J. Gregorio, I. Couto, P. Povoa, M. Viveiros

Research output: Contribution to journalMeeting Abstractpeer-review


Fighting antimicrobial resistance is a health top priority. Interventions aimed to reduce antimicrobialresistance, such as antibiotic stewardship programs, must be implemented. In order to be effective, those interventions, and the implementation process, should be matched with social-cultural context. The complexity of antibiotic stewardship programs can no longer be developed without considering organizational and information systems. To support antibiotic stewardship programs through the co-design and implementation, in collaboration with healthcare workers, of a decision-support system to monitor antibiotic resistance and improve antibiotic prescription.

The surveillance and clinical decision-support system was designed and implemented in three Portuguese hospitals, using a participative approach between researchers and healthcare workers following the Design Science Research Methodology.


Based on healthcare workers requirements, we developed HAITooL, a real-time surveillance and clinical decision-support system that integrates visualizations of patient, microbiology, and pharmacy data, facilitating clinical decision. HAITooL monitors antibiotic usage, rates of antibiotic resistant bacteria and allows early identification of outbreaks. It is a clinical decision-support tool that integrates evidence-based algorithms to support proper antibiotic prescription. HAITooL was considered very valuable to support monitoring of antibiotic resistant infections and an important tool for antibiotic stewardship program’s sustainability.

Antibiotic stewardship program implementation can be leveraged through a surveillance and clinical decision-support system such as HAITooL that allows antibiotic resistance monitoring and supports antibiotic prescription, once is adapted to the context and specific needs of healthcare workers and hospitals.

Key messages:
Antibiotic stewardship programs can benefit from well-integrated information decision-support systems.
Clinical information decision-support system should be designed using a participative approach between researchers and healthcare workers.
Original languageEnglish
Pages (from-to)186
Number of pages1
JournalEuropean Journal of Public Health
Issue numbersuppl_4
Publication statusPublished - Nov 2018

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