title: Survey of antibiotic control policies in university-affiliated teaching institutions.
abstract: OBJECTIVE
  To determine the type and extent of antibiotic control policies currently in use in a group of university-affiliated teaching institutions.
  
  
  METHODS
  A survey of antibiotic control policies and procedures (e.g., antibiotic order sheets, formulary restrictions, automatic stop orders for specific indications) was developed.
  
  
  METHODS
  The University Hospital Consortium (UHC), a nonprofit group of academic health centers located in 33 states throughout the US.
  
  
  METHODS
  The survey was mailed to 60 UHC members.
  
  
  RESULTS
  The survey was returned by 48 (80%) institutions. Most hospitals use either restrictions (81%) and/or official recommendations (56%) to manage antibiotic use. Antibiotics were restricted most commonly by service or unit (69%), indication (69%), or to the infectious disease service (60%). Antibiotic order sheets are used in 21 (44%) of the hospitals, of which 14 require completion by the prescriber. Monitoring of compliance with established restrictions is primarily the responsibility of the pharmacist processing the order (84%) and/or a clinical pharmacist (53%). When an order does not comply with restrictions or compliance cannot be determined, the prescriber is contacted prior to dispensing in 77% and 83% of the cases, respectively. In cases of noncompliance in which the prescriber refuses to alter an order to meet restrictions, 40% of hospitals refuse to dispense the drug and 35% dispense the drug but refer the case to another authority (infectious disease service or pharmacy and therapeutics committee).
  
  
  CONCLUSIONS
  Considering the widespread use of antibiotic control programs, further investigation of the success of such programs in optimizing drug therapy, improving patient outcome, and cutailing the antibiotic budget within and among specific institutions is warranted.
authors.affiliation: Department of Pharmacy, Albany Medical Center, NY, USA.
authors.forename: T S
authors.initials: TS
authors.lastname: Lesar
authors.forename: L L
authors.initials: LL
authors.lastname: Briceland
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics; D011307:Drug Prescriptions; D004363:Drug Utilization / Q000191:economics; D005572:Formularies, Hospital as Topic; D006785:Hospitals, University / Q000458:organization & administration*; D010595:Pharmacists; D010607:Pharmacy Service, Hospital / Q000458:organization & administration / Q000592:standards*; D010606:Pharmacy and Therapeutics Committee; D010820:Physicians
chemical_list: D000900:Anti-Bacterial Agents