Enhancing Decision-making for Diagnosis and Management of Respiratory Infection

One of the greatest medical advances of the 20st century was the discovery of antibiotics, and one of the gravest medical threats of the 21st century is antibiotic resistance, largely driven by overuse of antibiotics. Many factors contribute to the overuse of antibiotics including societal expectation, misdiagnosis of infection, and lack of knowledge surrounding risks and benefits. Barbara Jones, MD, and Matthew Samore, MD, used national data from the Department of Veterans Affairs to examine decision-making and practice patterns among providers prescribing antibiotics for patients diagnosed with acute respiratory infection. Their research team demonstrated considerable variability in provider's antibiotic prescribing practices as well as in their accuracy diagnosing patients with suspected pneumonia. They then assessed the effect of treatment choice on outcomes. The found that empirical broad-spectrum antibiotics targeting methicillin-resistant Staphylococcus aureus were associated with increased mortality in patients hospitalized for pneumonia. Current work is focused on providing clinicians with evidence-based decision support and feedback to support better clinical decisions.