Impact of a multidisciplinary approach on antibiotic consumption, cost and microbial resistance in a Czech hospital.
OBJECTIVE
The study objective was to evaluate the impact of a restrictive antibiotic policy, efficacy of inpatient therapeutic and prophylactic antibiotic regimens and susceptibility patterns of infecting bacteria in 2000-2004.


METHODS
A 500-bed general hospital in the Czech Republic.


METHODS
A retrospective computerized survey of antibiotic prescribing practices over a five-year period 2000-2004, using medical records and laboratory data from the hospital information system (HIS).


METHODS
Consumption of antibiotics expressed in defined daily doses (DDDs) and Euros per 1,000 bed days. Resistance to antibiotics, average length of hospital stay, rate of inpatients treated with antibiotics, number of nosocomial infections per 1,000 bed days, median length of hospital stay and total mortality.


RESULTS
Due to a restrictive antibiotic policy implemented in 2002, the use of several antibiotics in 2003 was significantly reduced but the consumption of several other antibiotics rose in 2003. In comparison with 2001 the cost of antibiotic agents (in Euro per 1,000 inpatient days) fell significantly by 31% in 2003 Euro 969.07 vs. Euro 671.34). The hospital saved about Euro 29,288 after the first year of implementation of the new antibiotic policy. The use of restricted antibiotics increased by 8%; however, the expenditure decreased by 26%. For non-restricted antibiotics, the use and expenditure decreased by 71% and 41%, respectively. Consequently, a net reduction of 55% Euro 804.36 vs. Euro 359.36) was achieved.


CONCLUSIONS
The intervention was effective in reducing the use and cost of antibiotics. The HIS is a helpful tool for observing and evaluating the impacts of the measures taken and can be used for assessment of pharmacotherapy outcomes.
Mach
Rene
R
Department of Pharmacy, Breclav Hospital, U nemocnice 1, 690 74, Breclav, Czech Republic.
Vlcek
Jiri
J
Prusova
Miroslava
M
Batka
Petr
P
Rysavy
Vladan
V
Kubena
Ales
A
D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D003363:Cost Control; D017046:Cost Savings; D003428:Cross Infection / Q000453:epidemiology; D018153:Czech Republic; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization / Q000706:statistics & numerical data; D006746:Hospital Bed Capacity, 500 and over; D006751:Hospital Information Systems; D006769:Hospitals, General; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008826:Microbial Sensitivity Tests; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents