Clinical decision support to improve antibiotic prescribing for acute respiratory infections: results of a pilot study.

Acute Respiratory Infections (ARIs) are the number one reason for antibiotic prescribing in the United States, and much antibiotic prescribing for ARIs is inappropriate. We designed an electronic health record-integrated, documentation-based clinical decision support system for the care of patients with ARIs, the ARI Smart Form. To evaluate the ARI Smart Form and assess the feasibility of performing a larger trial, we conducted a pilot study with 10 clinicians who used the ARI Smart Form with 26 patients. Clinicians prescribed antibiotics to 6 of 6 patients with antibiotic-appropriate diagnoses and to 3 of 20 (15%) patients with antibiotic-inappropriate diagnoses. The average duration of use of the ARI Smart Form was 7.5 (SD+/-4.5) minutes. Eight of 10 respondents reported that the ARI Smart Form was either time-neutral or timesaving. The ARI Smart Form requires further evaluation but has the potential to improve workflow and reduce inappropriate antibiotic prescribing.