Table 1.
Antimicrobial Stewardship Alerts Built in CDSS.
| Alert category and name | Type of alert |
|---|---|
| Therapeutic Antibiotic Monitoring (TAM) | |
| TAM Susceptibility known, inpatient (therapy de-escalation and escalation)a | Prebuilt |
| De-escalation Alert | |
| Vancomycin- and methicillin-susceptible Staphylococcus aureus | Custom-built |
| Daptomycin/linezolid and ampicillin/vancomycin susceptible Enterococcus | Custom-built |
| Micafungin and non–Candida glabrata | Custom-built |
| Escalation Alert | |
| Fluconazole and C glabrata | Custom-built |
| Micafungin and Cryptococcus spp. | Custom-built |
| TAM susceptibility known, inpatient | Custom-built |
| Drug interaction | |
| Ciprofloxacin and contraindicated drug interaction | Custom-built |
| Itraconazole or posaconazole and proton-pump inhibitor | Custom-built |
| Itraconazole and contraindicated drug interaction | Custom-built |
| Protease inhibitors and statins | Custom-built |
| Rifampin and contraindicated drug interaction | Custom-built |
| Sulfamethoxazole-trimethoprim and contraindicated drug interaction | Custom-built |
| Voriconazole and contraindicated drug interaction | Custom-built |
| ADR monitoring/avoidance | |
| Daptomycin and elevated CPK | Custom-built |
| Daptomycin and no CPK within 7 days of therapy | Custom-built |
Note. CDSS = clinical decision support systems; ADR = adverse drug reaction; CPK = creatine phosphokinase.
a
TAM susceptibility known alerts occur when susceptibility of an organism is available and marks an opportunity to de-escalate or escalate therapy based on cultures and susceptibility.