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Adverse Drug Events in Hospitalized Patients-Reply

John P. Burke, MD; David C. Classen, MD, MS; Stanley L. Pestotnik, MS, RPh; R. Scott Evans, PhD; James F. Lloyd
JAMA. 1997;277(17):1353. doi:10.1001/jama.1997.03540410031017.
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In Reply.  —Active surveillance for ADEs can prevent the unfortunate adversarial relationships between physicians and pharmacists that concern Dr Davis. Surveillance, rather than mandatory reporting, must be the core of the "concerted multidisciplinary effort" called for by Dr Rybacki. Using exactly this approach, we have published evidence that early notification of physicians can alert them to ongoing ADEs so that mild and moderate reactions don't progress to more serious conditions,1 focused surveillance can reduce the incidence of certain types of ADEs,2 and antibiotic management programs, including but not limited to computerized ordering, can reduce the incidence of ADEs to antibiotics by 75%.3,4 Indeed, we are the only center to have developed and implemented broad-based programs that prevent ADEs. The major reason for our success has been our focus on improving drug use at the bedside rather than on elucidating and cataloging all sources of inconsequential drug errors.Dr Davis


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