The Role of Electronic Medical Record in Enhancing Rational Antibiotics Prescription: A Systematic Review

Rachmat Kamaluddin, Wiku Bakti Bawono Adisasmito


Study Program of Hospital Administration, Faculty of Public Health,

Universitas Indonesia



Background: Antimicrobial resistance is a big problem in the world. Inappropriate use of antibiotics increases up to 36-54% in hospitals worldwide. One of the factors that trigger antimicrobial resistance is the prescription of irrational antibiotics. In the age of increasingly developing technology, a variety of medical equipment and support also developed, including electronic medical record (EMR). This study aimed to systema­ti­cally review the role of the electronic medical record in enhancing rational antibiotics pres­crip­tion.

Subjects and Methods: This was a systematic review using articles obtained from 4 electronic databases, namely Proquest, EBSCO, PubMed, and Scopus. The keywords used in this study were “electronic medical record” OR “electronic health record” OR “electronic patient data” AND “hospital” AND “rational antibiotic prescribing” OR “ra­ti­onal antimicrobial prescribing” OR “improve antibiotic prescribing” OR “antibiotic re­sis­tance “OR “antimicrobial resistance”. The data were obtained from publication in 2014 to 2019, observational study, conducted in hospital, and related to EMR. The main outcome was the change in prescription from irrational to rational use of anti­bi­o­tics. The data were reviewed based on the PRISMA flow diagram.

Results: Eight of 5549 articles met the inclusion criteria and were reviewed. Four of 8 articles discussed additional information technology (IT) tools that were technologica­l­ly linked to EMR. One article discussed government regulation. Two articles discussed hos­pital sys­tem. One articles discussed collaboration between EMR data and educa­tion­al promo­tion. EMR provided complete information about the patient’s condition, his­tory of the disease, the pattern of therapy administration, and the cost of treatment in the hospital. However, EMR itself was not enough. Program support, additional IT sys­tem, and re­gu­lation, were needed to change the behavior of rational antibiotic pres­cription.

Conclusion: EMR can provide an overview of the medical record data, including pat­terns of antibiotics drug use. It helps the doctors to provide rational therapy easier by increase regulation, hospital system, or additional tools that support EMR in the case to reduce antimicrobial resistance.

Keywords: electronic medical record, antimicrobial resistance, improve antibiotic prescribing, hospital

Correspondence: Rachmat Kamaluddin. Study Program of Hospital Administration, Faculty of Public Health, Universitas Indonesia. Jl. Margonda Raya, Pondok Cina, Beji, Depok 16424, West Java. Email: Mobile: 081319420­526.


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