PhD defence H. (Hassana) Akhloufi

This thesis focuses on the development and evaluation of clinical decision support systems (CDSSs) to improve antibiotic use in hospitals. These CDSSs have been developed and implemented as part of antibiotic stewardship. First, this thesis provides insight into (in)appropriateness of antibiotic prescriptions in a tertiary care center in the Netherlands. It shows that antibiotic therapy was inappropriate in 29.3% of prescribed antibiotics. An unjustified prescription was the most common reason for an inappropriate prescription.  

The development and evaluation of two different CDSSs are then prescribed. One of these CDSSs identifies intravenous (iv) to oral antibiotic switch candidates. This CDSS is based on consensus-based iv to oral switch criteria developed with a RAND-modified Delphi procedure. This CDSS is effective in helping antimicrobial stewardship teams to select candidates for the switch from iv to oral antibiotics. Moreover, even in a hospital with an active ID consultancy service this CDSS has additional value.  Another CDSS on which this thesis focuses is developed for empirical antibiotic therapy. Using a recently developed systematic framework for reporting CDSS interventions, a guidance is given of its development and validation. It shows the usefulness of this framework. In addition, our data indicate that CDSS recommendations are not always adhered to and incorrect use of the system plays an important role in this.

Due to corona, the PhD defences do not take place publicly in the usual way in the Senate Hall or in the Professor Andries Querido Room. The candidates will defend their dissertation either in a small group or online.