[A hospital-wide intervention program to optimize the utilization quality of carbapenems and glycopeptides].
OBJECTIVE
To investigate the impact of intervention program upon improvement of utilization quality of carbapenems and glycopeptides.


METHODS
Multifaceted intervention program of carbapenems and glycopeptides was conducted at our hospital. It involved written justification forms, expert consultation committee meetings, audit, feedback and re-feedback. From November 1, 2007 until October 31, 2008, retrospective audit and feedback were performed on all patients dosed with carbapenems or glycopeptides. Case reports were reviewed and data of ratio of appropriate antibiotic use, length of hospital stay, total cost, mortality and rate of vancomycin-resistant Enterococci (VRE) were collected and compared between the first and second half year of antibiotic intervention program.


RESULTS
A total of 397 cases were reviewed, 75 cases discussed at expert committee meetings and 58 feedback letters delivered to responsible doctors. The consumption of both carbapenems and glycopeptides decreased. The appropriate use of carbapenems and glycopeptides increased from 37.8% (45/119) to 53.5% (48/127, P < 0.05) and from 45.6% (36/79) to 63.9% (46/72, P < 0.05) respectively. The total cost and mortality of patients dosed with glycopeptides decreased from a median of RMB 65,700 (30,300 - 146,900) yuan to 55,700 (36,700 - 90,900) yuan, and from 39.2% to 26.4% respectively. The rate of VRE decreased from 5.63% in 2007 to 3.80% during the second half year of 2008.


CONCLUSIONS
Antibiotic intervention program of carbapenems and glycopeptides is effective in decreasing the inappropriate antibiotic use.
Cao
Bin
B
Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Diseases, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China.
Sun
Li-ying
LY
Liu
Kun
K
Li
Rui-sheng
RS
Liu
Ying-mei
YM
Tong
Zhao-hui
ZH
Li
Wen-xiong
WX
Pan
Shi-fen
SF
Yang
Yong
Y
Huang
Ke-wu
KW
Li
Chun-sheng
CS
Chen
Yang-yu
YY
Wang
He-yao
HY
Li
Bin
B
Hu
Yan-sheng
YS
Hou
Sheng-cai
SC
Wang
Chen
C
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D015780:Carbapenems / Q000008:administration & dosage*; D017723:Drug Utilization Review; D006020:Glycopeptides / Q000008:administration & dosage*; D006801:Humans; D010605:Pharmacy Administration
D000900:Anti-Bacterial Agents; D015780:Carbapenems; D006020:Glycopeptides