Year: 2025
Type: article
Abstract: Relevance. Аntimicrobial prophylaxis in surgery (APS) is an important component of strategic healthcare programs aimed at reducing antibiotic resistance. The use of modern APS techniques also reduces the cost of prevention and treatment of surgical infection. However, the actual clinical practice of APS at the present time often differs from the scientifically based one, there is a suboptimal, excessive prescription of antibacterial agents. The introduction of APS using a Medical Decision Support System (DSS) can increase doctors' commitment to following modern medical technology. Objective. To develop and implement a APS protocol for a multidisciplinary emergency hospital. To develop and implement a mobile application, a chatbot for choosing a decision on the mode of perioperative antibiotic prophylaxis. Methods. Clinical and economic assessment of the "cost of illness" in the emergency department of surgical departments. Literary — an overview of regulatory documents as the basis of the APS protocol. Python programming method, digital application development. Development taking into account State industry standard R 71671-2024 "Medical decision support systems using artificial intelligence". Administrative — issuing orders and orders for the medical institution on the procedure for implementing the protocol, monitoring compliance with the protocol. Results. A local APS protocol has been developed. Based on the APS protocol, standard solutions for choosing the APS method have been compiled. Applications (Telegram chatbots) have been developed to facilitate this choice for the doctor who decides on the APS regime. It has been established that the commitment to the implementation of the PAP protocol continues to grow. This may be due to the absence of an increase in cases of infection of the surgical wound, despite a multiple decrease in the use of antimicrobial agents. The visibility and convenience of using APS mode selection algorithms using digital technology are also revealed. Conclusions. The implementation of the local protocol is effectively carried out using digital technologies, a system for supporting medical decision-making using artificial intelligence. The implementation of this APS protocol has made it possible to achieve significant cost reductions while maintaining the effectiveness of antimicrobial prophylaxis.
Authors: K. A. Koshechkin, O. A. Leontyeva, S. S. Leontyev, A. M. Uridin
Institutions: Sechenov University, Tula State University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4412500333