title: [Results of a counselling programme in antibiotic treatment in a secondary hospital].
abstract: BACKGROUND
  The inappropriate use of antimicrobial agents may contribute to the development of bacterial resistance to the principal antimicrobial drugs. There is no provision in the immediate future of marketing of new broad-spectrum antibiotics, especially with activity against Enterobacteriaceae, so programs should be implemented to optimize antimicrobial therapy. We describe the results of a year of a counselling program in antibiotic treatment in a secondary Andalusian hospital.
  
  
  METHODS
  We describe 276 interventions of a multidisciplinary non-compulsory counselling program of antimicrobial management on the Costa del Sol Hospital in Marbella. We evaluated the adequacy of empirical treatment, possibility of antibiotic de-escalation, duration and dose used. We analyzed the evolution of the sensitivity profile of the main microorganisms as well as a cost-effective analysis.
  
  
  RESULTS
  90% of the recommendations were accepted. The main actions were assessment of empirical therapy and deescalation in relation with the result of cultures. The main drugs tested were imipenem, meropenem, cefepime, and linezolid. The sensitivity profile of imipenem and meropenem improved slightly over previous years. It was found a considerable savings in annual drug spending.
  
  
  CONCLUSIONS
  The non-compulsory counselling programs are useful tools for optimization of antimicrobial therapy, can prevent an increase of antimicrobial resistance and reduce the cost of antibiotic treatment.
authors.affiliation: Grupo Enfermedades Infecciosas-Medicina Interna, Hospital Costa del Sol, Autovía A-7 Km 189, 29603. Marbella (Málaga), España. alfarco@gmail.com
authors.forename: Alfonso
authors.initials: A
authors.lastname: del Arco
authors.forename: Begoña
authors.initials: B
authors.lastname: Tortajada
authors.forename: Javier
authors.initials: J
authors.lastname: de la Torre
authors.forename: Julián
authors.initials: J
authors.lastname: Olalla
authors.forename: José Luís
authors.initials: JL
authors.lastname: Padra
authors.forename: Natalia
authors.initials: N
authors.lastname: Montiel
authors.forename: Javier
authors.initials: J
authors.lastname: García-Alegría
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D003363:Cost Control; D003376:Counseling; D016527:Drug Costs; D004352:Drug Resistance, Microbial; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D006748:Hospital Departments; D006779:Hospitals, Public; D006801:Humans; D055552:Infectious Disease Medicine; D033183:Interdisciplinary Communication; D007388:Internal Medicine; D007755:Laboratories, Hospital / Q000458:organization & administration; D008510:Medication Systems, Hospital / Q000458:organization & administration; D008826:Microbial Sensitivity Tests; D016134:Organizational Policy; D010607:Pharmacy Service, Hospital / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000191:economics; D015397:Program Evaluation; D013030:Spain
chemical_list: D000900:Anti-Bacterial Agents