Using domain knowledge to improve intelligent decision support in intensive medicine - a study of bacteriological infections

Nowadays antibiotic prescription is object of study in many countries. The rate of prescription varies from country to country, without being found the reasons that justify those variations. In intensive care units the number of new infections rising each day is caused by multiple factors like inpatient length of stay, low defences of the body, chirurgical infections, among others. In order to complement the support of the decision process about which should be the most efficient antibiotic it was developed a heuristic based in domain knowledge extracted from biomedical experts. This algorithm is implemented by intelligent agents. When an alert appear on the presence of a new infection, an agent collects the microbiological results for cultures, it permits to identify the bacteria, then using the rules it searches for a role of antibiotics that can be administered to the patient, based on past results. At the end the agent presents to physicians the top-five sets and the success percentage of each antibiotic. This paper presents the approach proposed and a test with a particular bacterium using real data provided by an Intensive Care Unit.This work has been supported by FCT – Fundação para a Ciência e Tecnologia in the scope of the project: Pest-OE/EEI/UI0319/2014 and PEst-OE/EEI/UI0752/2014. The authors would like to thank FCT (Foundation of Science and Technology, Portugal) for the financial support through the contract PTDC/EEI-SII/1302/2012 (INTCare II)