title: Optimizing antibiotic use in hospitals: the role of population-based antibiotic surveillance in limiting antibiotic resistance. Insights from the society of infectious diseases pharmacists.
abstract: To minimize antibiotic resistance, pharmacists increasingly are becoming involved in antibiotic surveillance, formulation of antibiotic use policies, and day-to-day control of problematic antibiotic use. Population-based antibiotic surveillance has become common with the proliferation of electronic databases. The most widely applied measure of antibiotic consumption is the defined daily dose/1000 patient days. Most studies correlating antibiotic consumption with resistance have focused on antibiogram-related end points; antibiogram data generally reflect institutional nosocomial infection patterns. Most study designs have been derived from traditional epidemiology such as case-control with regression modeling or simple linear regression; however, these methods have limitations. Several experimental designs show promise. Many historical-control studies, including a multicentered study, suggest that population-based antibiotic surveillance and policy intervention can decrease antibiotic resistance in hospitals. Further research on the relationships among antibiotic surveillance, structured antibiotic policy interventions, and other microbiologic, patient-oriented, and economic end points is needed.
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, Idaho State University, Pocatello, Idaho, USA. kmk@otc.isu.edu
authors.forename: Karl
authors.initials: K
authors.lastname: Madaras-Kelly
mesh_terms: D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004351:Drug Resistance; D017723:Drug Utilization Review / Q000379:methods*; D019983:Guideline Adherence / Q000592:standards; D006761:Hospitals / Q000592:standards*; D006801:Humans; D010607:Pharmacy Service, Hospital / Q000379:methods / Q000592:standards; D011358:Product Surveillance, Postmarketing / Q000379:methods*
chemical_list: D000890:Anti-Infective Agents