title: Rational antibiotic use.
abstract: BACKGROUND
  Development of resistance to antimicrobial agents and increase of cost as the result of unnecessary and inappropriate use of antibiotics has become a global health problem. Therefore many strategies, which are aimed at optimizing antibiotic therapy, have been developed until now. In Turkey, an antibiotic restriction policy as a governmental solution was applied to decrease the antibiotic use and especially costs by Ministry of Health in 2003. The aim of this study is to evaluate the rational antibiotic use and the impact of the implementation of new restriction policy, with their reinforcement by infectious disease specialist, on the hospital wide use of antibiotics.
  
  
  METHODS
  The data of the inpatients received antibiotics (n=495) during January-June 2006 were compared with our previous study performed by the same methodology before the restriction policy in 1998. In both studies, prospective active daily surveillance of patients was performed by three infectious disease specialists. The appropriateness of antibiotic therapy was determined using the criteria described by Kunin and Jones. The data were analyzed by using SPSS for Windows.
  
  
  RESULTS
  While the rate of antibiotic use decreased from 16.6% to 11.3%, rational use increased after the restriction policy (p<0.001). Besides the specific antibiotic use increasing, prophylactic antibiotic use was found decreased (p<0.001). Mostly determined irrationality was the prophylactic uses in both studies. As expected, infectious disease specialist examinations resulted in an increase in the appropriate antibiotic use.
  
  
  CONCLUSIONS
  The restriction policy was effective in decreasing the antibiotic consumption and increasing the rational antibiotic prescription in our hospital.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey. otunger@hotmail.com
authors.forename: Ozlem
authors.initials: O
authors.lastname: Tunger
authors.forename: Yeliz
authors.initials: Y
authors.lastname: Karakaya
authors.forename: C Banu
authors.initials: CB
authors.lastname: Cetin
authors.forename: Gonul
authors.initials: G
authors.lastname: Dinc
authors.forename: Hakan
authors.initials: H
authors.lastname: Borand
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D003141:Communicable Diseases / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000592:standards*; D004352:Drug Resistance, Microbial; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D008875:Middle Aged; D014421:Turkey
chemical_list: D000900:Anti-Bacterial Agents