title: Economic impact of a rational use of antibiotics in intensive care.
abstract: OBJECTIVE
  To evaluate the economic impact of a rational policy in antibiotic treatment.
  
  
  METHODS
  Comparative study with a retrospective and a prospective part.
  
  
  METHODS
  An 11-bed intensive care unit (ICU) in a general hospital.
  
  
  METHODS
  All patients admitted to the unit in 1994, 1995 and 1996.
  
  
  METHODS
  In 1995, a program of cost control was started and a contract of agreed objectives signed with the director of the hospital. This contract included a commitment to refund the eventual savings in order to improve the quality of care. Prescribing protocols were established by consensus as guidelines for a rational policy in antibiotic therapy.
  
  
  RESULTS
  The cost of antibiotic therapy, the patients' characteristics and the incidence of nosocomial infection were compared prior to and during the program. The expenses for antibiotic drugs decreased by 19% in 1995 and by 22% in 1996. Most of the savings were refunded to the ICU and contributed to the employment of an additional nurse and the purchase of new material. In number of patients, type of disease, mean age, Simplified Acute Physiology Score, occupancy rate, length of stay, omega score, artificial ventilation, readmission within 7 days, mortality and incidence of nosocomial infection, no significant difference was found.
  
  
  CONCLUSIONS
  We proved a positive economic impact of a rational policy in antibiotic therapy realized with a contract of agreed objectives. The savings made while applying our program of cost control were used to improve the quality of care.
authors.affiliation: Intensive Care Unit, Font Pré Hospital, Toulon, France. ph-blanc@-fguyon.fr
authors.forename: P
authors.initials: P
authors.lastname: Blanc
authors.forename: B E
authors.initials: BE
authors.lastname: Von Elm
authors.forename: A
authors.initials: A
authors.lastname: Geissler
authors.forename: I
authors.initials: I
authors.lastname: Granier
authors.forename: A
authors.initials: A
authors.lastname: Boussuges
authors.forename: J
authors.initials: J
authors.lastname: Durand Gasselin
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000517:prevention & control*; D003428:Cross Infection / Q000517:prevention & control*; D016527:Drug Costs; D017723:Drug Utilization Review; D005260:Female; D005602:France; D017721:Hospital Costs; D006769:Hospitals, General; D006801:Humans; D007362:Intensive Care Units / Q000191:economics* / Q000592:standards / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016134:Organizational Policy; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents