The Medical journal of Australia
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The Problem-Oriented Medical Information System (PROMIS) is a computer-based data system which was developed in the United States to provide an improved approach to clinical teaching and patient care. The introduction of this system into Australian medical schools and hospitals is proposed. ⋯ The merits of the system, and the salient features of its operation, are discussed. Some potential constraints and difficulties in its implementation, none of which appears insurmountable, are outlined briefly.
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Three surveys of antibiotic use have been conducted at The Royal Melbourne Hospital. The first was conducted in 1978, before the introduction of the booklet, Antibiotic Guidelines; the second was conducted eight months after, and the most recent, four years after, its distribution. In 1978, 30% of 563 patients surveyed were receiving antibiotic therapy; this proportion declined to 28% of 967 patients studied in 1982. ⋯ Certain inappropriate prescribing patterns persisted, such as the use of amoxycillin for the treatment of primary pneumonia, surgical antibiotic prophylaxis which was started too late, and the failure to simplify therapy when the results of microbiological investigations became available. Antibiotic guidelines facilitate the auditing of antibiotic usage and aid rational prescribing. Nevertheless, additional measures appear necessary if specific patterns of misuse of antibiotic agents are to be corrected.