title: Impact of a computerized integrated antibiotic authorization system.
abstract: BACKGROUND
  Overuse and abuse of antibiotics is a major cause of microbial resistance. Within the hospital setting such overuse necessitates real-time supervision by infectious diseases (ID) specialists.
  
  
  OBJECTIVE
  To evaluate the impact of a recently introduced computerized antibiotic authorization system on the pharmacy budget.
  
  
  METHODS
  The study was performed in a 400 bed university hospital. With the new system, antibiotic requests are entered electronically by the ward physician and reviewed within minutes to hours by ID specialists. The feedbacks are seen in the wards and pharmacy. Successive years, one before and the other after introduction of the system, were compared.
  
  
  RESULTS
  During the first year with the new system 7167 antibiotic requests were entered; 20% of them were rejected, mainly for improper indication (43% of the rejections). During that year the antibiotic expenditure was reduced by 17%, compared to the previous year (approximately equal to 200,000 US$), and was against the trend of the last 5 years. Of the 35 antibiotics under the control of the ID team, the use of 7 was probably curtailed by the supervision. Pareto analysis revealed that four drugs constituted > 50% of the pharmacy's expenses. The mortality rate (per 1000 hospitalization days) during those 2 years fell from 4.0 to 3.8.
  
  
  CONCLUSIONS
  Computerized antibiotic control by ID specialists is a feasible cost-saving new modality that may help reduce unnecessary antibiotic prescriptions.
authors.affiliation: Department of Infectious Diseases, Bnai Zion Medical Center, affiliated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. israel.potasman@b-zion.org.il
authors.forename: Israel
authors.initials: I
authors.lastname: Potasman
authors.forename: Gabriela
authors.initials: G
authors.lastname: Naftali
authors.forename: Moti
authors.initials: M
authors.lastname: Grupper
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017046:Cost Savings; D017723:Drug Utilization Review; D017721:Hospital Costs; D006801:Humans; D007557:Israel; D050316:Medical Order Entry Systems / Q000191:economics / Q000458:organization & administration*; D008510:Medication Systems, Hospital / Q000458:organization & administration; D010607:Pharmacy Service, Hospital / Q000191:economics / Q000458:organization & administration*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data
chemical_list: D000900:Anti-Bacterial Agents