title: Efficacy and cost-effectiveness of antibiotic monitoring at a Veterans Administration hospital.
abstract: A rigorous, continuously monitored antibiotic programme was initiated at our Veterans Administration hospital following evidence of inappropriate antibiotic usage. Seven hundred and thirty-one patients, mainly male, with an average age of 60 years were involved in the study; 378 were evaluable prior to policy implementation and 273 subsequently. The overall prevalence of deaths and average length of antibiotic therapy were less during the post-policy period. The number of antibiotic doses per patient was decreased by 24%. Drug costs were reduced by 32% post-policy, due largely to increased use of the longer-acting cephalosporins ceftriaxone and cefotetan. A 23% reduction in antibiotic acquisition costs was achieved over the 3-year period of the study, without detrimental effects on patient outcome.
authors.affiliation: Infectious Disease Section, Veterans Administration Hospital, Palo Alto, Calif.
authors.forename: P
authors.initials: P
authors.lastname: O'Hanley
authors.forename: L
authors.initials: L
authors.lastname: Rodondi
authors.forename: R
authors.initials: R
authors.lastname: Coleman
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D003362:Cost-Benefit Analysis; D004363:Drug Utilization / Q000191:economics*; D005260:Female; D005572:Formularies, Hospital as Topic; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy*; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents