[Impact of a non-compulsory antibiotic control program (PACTA): cost reductions and decreases in some nosocomial infections].
BACKGROUND
Antibiotics account for 30% of hospital pharmacy expenses. More than 50% of the prescriptions are considered inappropriate; hence, programs devoted to optimizing the prescription of antibiotics should be developed. We present the results of a non-compulsory program for the assessment and control of antibiotic treatment in the University Hospital 12 de Octubre in Madrid.


METHODS
The program was applied in the hospitalization units of six medical and surgical departments. Treatments in all patients were checked daily and recommendations were made in writing, according to previously established criteria. The program was used for 12 months and the results were compared with those of the previous 12 months.


RESULTS
1,280 treatments were reviewed and 524 recommendations were made (80% of them were accepted). There was a 13.82% reduction in the number of defined daily doses of antibiotics/100 inpatient-days. Antibiotic expenditure decreased by 65,352 euros (5,446 euros/month), implying a reduction of 1.21 euros/hospitalization-bed/day. There were no statistically significant differences in length of hospital stay or mortality between the two periods. A reduction in the incidence of Clostridium difficile diarrhea (p < 0.0001) and Candida spp. isolations (p < 0.05) was observed.


CONCLUSIONS
Following application of a non-compulsory control program, antibiotic prescription improved and expenditure decreased, with no change in length of hospital stay or mortality. There was a reduction in the incidence of some nosocomial infections. Acceptation of the program by the physicians of the departments implicated was favorable.
López-Medrano
Francisco
F
Unidad de Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, Madrid, España. flmedrano@yahoo.es
San Juan
Rafael
R
Serrano
Olga
O
Chaves
Fernando
F
Lumbreras
Carlos
C
Lizasoaín
Manuel
M
Herreros de Tejada
Alberto
A
Aguado
José María
JM
D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001424:Bacterial Infections / Q000188:drug therapy; D002177:Candidiasis / Q000453:epidemiology / Q000517:prevention & control; D019090:Case Management / Q000592:standards; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000453:epidemiology / Q000517:prevention & control; D003363:Cost Control / Q000458:organization & administration*; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D016527:Drug Costs; D024901:Drug Resistance, Multiple, Bacterial; D004363:Drug Utilization; D017723:Drug Utilization Review / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology / Q000517:prevention & control; D017408:Guidelines as Topic; D006748:Hospital Departments / Q000191:economics / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D012189:Retrospective Studies; D015163:Superinfection / Q000209:etiology / Q000517:prevention & control
D000900:Anti-Bacterial Agents