A Hospitalwide Intervention Program to Optimize the Quality of Antibiotic Use: Impact on Prescribing Practice, Antibiotic Consumption, Cost Savings, and Bacterial Resistance

Several findings from Argentina provide compelling evidence of the need for more rational use of antimicrobial agents. Thus, a multidisciplinary antimicrobial treatment committee for the development of a hospital-wide intervention program was formed to optimize the quality of antibiotic use in hospi...

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Bibliographic Details
Published in:Clinical infectious diseases 2003-07, Vol.37 (2), p.180-186
Main Authors: Bantar, Carlos, Sartori, Beatriz, Vesco, Eduardo, Heft, Claudia, Saúl, Mariano, Salamone, Francisco, Oliva, María Eugenia
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - economics
Antibacterial agents
Antibiotics
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antimicrobials
Biological and medical sciences
Cephalosporins
Cost Savings
Cross Infection - mortality
Drug Prescriptions
Drug Resistance, Bacterial
Drug Utilization - economics
Hospital costs
Hospitalization
Hospitals
Humans
Infections
Infectious diseases
Intensive Care Units
Major Articles
Medical sciences
Microbial Sensitivity Tests
Pharmacology. Drug treatments
Physicians
Practice Patterns, Physicians
Statistics as Topic
Teaching hospitals
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Summary:Several findings from Argentina provide compelling evidence of the need for more rational use of antimicrobial agents. Thus, a multidisciplinary antimicrobial treatment committee for the development of a hospital-wide intervention program was formed to optimize the quality of antibiotic use in hospitals. Four successive steps were developed during 6-month periods: baseline data collection, introduction of a prescription form, education, and prescribing control. Sustained reduction of drug consumption was shown during the study (R2 = 0.6885; P = .01). Total cost savings was US$913,236. To estimate the consumption of R2p0.6885 Pp.01 cefepime and aminopenicillin-sulbactam in relation to that of the third-generation cephalosporins, 2 indices were calculated: Icfp and Iams, respectively. Decreasing resistance to ceftriaxone by Proteus mirabilis and Enterobacter cloacae proved to be associated with increasing Icfp. Decreasing rates of methicillin-resistant Staphylococcus aureus were related to increasing Iams. The present study indicates that a systematic program performed by a multidisciplinary team is a cost-effective strategy for optimizing antibiotic prescribing.
ISSN:1058-4838
1537-6591
DOI:10.1086/375818