Information technology for optimizing the management of infectious diseases

As with other areas of health care, a significant need exists for improving the quality of infectious diseases (ID) management. This is evidenced by reports of high rates of inadequate or inappropriate antimicrobial therapy in both the inpatient and outpatient settings. For example, 55% of the 41 million antimicrobial prescriptions for upper-respiratory-tract infections in 1998 were considered inappropriate.1 Rates of inadequate or inappropriate antimicrobial therapy in the inpatient setting have been estimated to be as high as 25–50%.2,3 Antimicrobials are also one of the most common types of medications involved in errors,4,5 accounting for 39.7% of medication errors in one tertiary care teaching hospital.4 The consequences of such inappropriate antimicrobial use have been extensively reported in the medical literature and include unnecessary health care-related costs,1 adverse events,4 and increased mortality.2,6,–8 The appropriateness of the initial empiric antimicrobial therapy has been identified as perhaps the single most important factor determining whether a critically ill patient survives an infection.6