title: A survey of inpatient antibiotic use in a teaching hospital.
abstract: To assess the appropriateness of inpatient antibiotic use, a 4-week prospective survey in medical, surgical and gynaecological wards was undertaken at Groote Schuur Hospital. A total of 224 prescriptions comprising 680 antibiotics were analysed. Of all patients in the medical, gynaecology and surgery wards, 27%, 26.5% and 32%, respectively, were prescribed antibiotics. The greatest number of inappropriate prescriptions--54%--were found in the gynaecology ward. Prophylactic antibiotic use was highest in the surgical ward at 41% where a very satisfactory 91% was considered appropriate, whereas 66% of gynaecological prophylaxis was inappropriate. Therapeutic use was highest and more often appropriate in the medical wards. Antibiotics classified as restricted according to the hospital antibiotic policy were generally used appropriately, whereas inappropriate choice, dose, frequency of administration, duration, and unnecessary antibiotic use were encountered in 22-100% of cases with unrestricted antibiotics. Particular problems pinpointed in this survey included excessive dosages of penicillin G and amoxycillin, an irrational protocol for the treatment of pelvic sepsis in gynaecology, and frequent inappropriate selection of erythromycin. The greatest expenditure was on amikacin, the only aminoglycoside allowed according to the existing antibiotic policy.
authors.affiliation: Department of Pharmacology, University of Cape Town.
authors.forename: B
authors.initials: B
authors.lastname: Till
authors.forename: L
authors.initials: L
authors.lastname: Williams
authors.forename: S P
authors.initials: SP
authors.lastname: Oliver
authors.forename: P I
authors.initials: PI
authors.lastname: Pillans
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003365:Costs and Cost Analysis; D004363:Drug Utilization; D005260:Female; D006757:Hospital Units; D006784:Hospitals, Teaching; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011446:Prospective Studies; D013019:South Africa
chemical_list: D000900:Anti-Bacterial Agents