title: A hospitalwide intervention program to optimize the quality of antibiotic use: impact on prescribing practice, antibiotic consumption, cost savings, and bacterial resistance.
abstract: 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 913,236 US dollars. To estimate the consumption of 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.
authors.affiliation: Committee for Prevention and Control of Nosocomial Infection, Hospital San Martín, Paraná, Entre Ríos, Argentina. cbantar@arnet.com.ar
authors.forename: Carlos
authors.initials: C
authors.lastname: Bantar
authors.forename: Beatriz
authors.initials: B
authors.lastname: Sartori
authors.forename: Eduardo
authors.initials: E
authors.lastname: Vesco
authors.forename: Claudia
authors.initials: C
authors.lastname: Heft
authors.forename: Mariano
authors.initials: M
authors.lastname: Saúl
authors.forename: Francisco
authors.initials: F
authors.lastname: Salamone
authors.forename: María Eugenia
authors.initials: ME
authors.lastname: Oliva
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics*; D017046:Cost Savings; D003428:Cross Infection / Q000401:mortality; D011307:Drug Prescriptions; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization / Q000191:economics; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D010818:Practice Patterns, Physicians'; D013223:Statistics as Topic
chemical_list: D000900:Anti-Bacterial Agents