title: [Impact of a non-compulsory antibiotic control program (PACTA): cost reductions and decreases in some nosocomial infections].
abstract: 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.
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, Madrid, España. flmedrano@yahoo.es
authors.forename: Francisco
authors.initials: F
authors.lastname: López-Medrano
authors.forename: Rafael
authors.initials: R
authors.lastname: San Juan
authors.forename: Olga
authors.initials: O
authors.lastname: Serrano
authors.forename: Fernando
authors.initials: F
authors.lastname: Chaves
authors.forename: Carlos
authors.initials: C
authors.lastname: Lumbreras
authors.forename: Manuel
authors.initials: M
authors.lastname: Lizasoaín
authors.forename: Alberto
authors.initials: A
authors.lastname: Herreros de Tejada
authors.forename: José María
authors.initials: JM
authors.lastname: Aguado
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents