title: Long-term antibiotic cost savings from a comprehensive intervention program in a medical department of a university-affiliated teaching hospital.
abstract: We tested a low-cost, multifaceted intervention program comprising formulary restriction measures, continued comprehensive education, and guidelines to improve in-hospital use of antibiotics and related costs. In a short-term analysis, total antibiotic consumption per patient admitted, which was expressed as defined daily doses (DDD), decreased by 36% (P < .001), and intravenous DDDs decreased by 46% (P < .01). Overall expenditures for antibiotic treatment decreased by 53% (100 US dollars per patient admitted). The 2 main cost-lowering factors were a reduction in prescription of antibiotics (35% fewer treatments; P < .0001) and more diligent use of 5 broad-spectrum antibiotics (23% vs. 10% of treatments; P = .001). Quality of care was not compromised. A pharmacy-based, prospective, long-term surveillance of DDDs and costs over 4 years showed an ongoing effect. This comprehensive intervention program, which aimed to reduce antibiotic consumption and costs, was highly successful and had long-lasting effects.
authors.affiliation: Department of Internal Medicine, Kantonsspital Schaffhausen, Switzerland. sigmund.ruettimann@kssh.ch
authors.forename: Sigmund
authors.initials: S
authors.lastname: Rüttimann
authors.forename: Barbara
authors.initials: B
authors.lastname: Keck
authors.forename: Cornelia
authors.initials: C
authors.lastname: Hartmeier
authors.forename: Andreas
authors.initials: A
authors.lastname: Maetzel
authors.forename: Heiner C
authors.initials: HC
authors.lastname: Bucher
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy; D017046:Cost Savings; D016527:Drug Costs; D004363:Drug Utilization; D005260:Female; D005572:Formularies, Hospital as Topic; D006784:Hospitals, Teaching; D006785:Hospitals, University; D006801:Humans; D008297:Male; D013995:Time; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents