title: Changes in antibiotic use, cost and consumption after an antibiotic restriction policy applied by infectious disease specialists.
abstract: The study was designed to compare antibiotic use, cost and consumption before and after an initiation of an antibiotic-restriction policy in our hospital. The policy was applied in 2003, and the prescription of two groups of antibiotics (intravenously used and expensive antibiotics) was restricted. A prescription for the restricted antibiotics could be obtained with approval by an infectious disease specialist (IDS). All the hospitalized patients who received antibiotics were evaluated by a cross-sectional study with standard criteria. The annual cost and consumption of antibiotics were evaluated. After restriction, the rate of antibiotic use decreased from 52.7 to 36.7% (P < 0.001), and the appropriate use increased from 55.5 to 66.4% (P < 0.05). Appropriate use was higher for restricted antibiotics (88.4%) than for unrestricted ones (58.2%) (P < 0.001), and higher in the presence of ID consultation (97.5%) than in the absence of consultation (55.7%) (P < 0.001). Culture-based treatment was increased, and appropriate use in such cases (93.0%) was higher than empirical treatment (33.3%) (P < 0.001). After the restriction policy, consumption of antibiotics belonging to the restricted groups was decreased by 44.8%. Total expenditure of all antibiotics was decreased by 18.5%, and the savings were US$332,000 per year. This restriction policy was effective in promoting rational antibiotic prescription and lowering antibiotic cost and consumption in our hospital.
authors.affiliation: Department of Infectious Diseases, Ataturk University Medical School, Erzurum, Turkey. zozkurt@atauni.edu.tr
authors.forename: Zulal
authors.initials: Z
authors.lastname: Ozkurt
authors.forename: Serpil
authors.initials: S
authors.lastname: Erol
authors.forename: Ayten
authors.initials: A
authors.lastname: Kadanali
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ertek
authors.forename: Kemalettin
authors.initials: K
authors.lastname: Ozden
authors.forename: Mehmet A
authors.initials: MA
authors.lastname: Tasyaran
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics*; D001424:Bacterial Infections / Q000188:drug therapy*; D017046:Cost Savings; D016527:Drug Costs / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization / Q000706:statistics & numerical data; D006739:Hospital Administration; D006801:Humans; D008511:Medicine; D016134:Organizational Policy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D013038:Specialization
chemical_list: D000900:Anti-Bacterial Agents