title: Impact of a hospital-wide antibiotic restriction policy program on the resistance rates of nosocomial Gram-negative bacteria.
abstract: BACKGROUND
  To evaluate the impact of an antibiotic restriction policy on antibiotic consumption and Gram-negative resistance rates, in an environment of antibiotic overconsumption and increasing resistance rates for nosocomial pathogens.
  
  
  METHODS
  The study was a 'before and after' trial of 18-month duration; the antibiotic restriction policy program was implemented in 1998-2000 and was based on a government program addressed by the Ministry of Health to public hospitals on a national basis. This included prescribing of all newer antibiotics on an order form, auditing of the order forms and consultation with infectious diseases (ID) specialists, dispensing of treatment and prophylaxis guidelines, feedback, and face-to-face education. Antibiotic consumption and Gram-negative resistance rates were recorded before and after the intervention.
  
  
  RESULTS
  Despite the addition of a new 40-bed ID department in the hospital during the 'after' period, the consumption of restricted antibiotics was significantly reduced by 42% (and their cost by 31%). Gram-negative resistance rates for Pseudomonas, Klebsiella, and Enterobacter, serving as index microorganisms for Gram-negative nosocomial pathogens, were significantly reduced during the 'after' period, even against antibiotics for which there was an increase in consumption.
  
  
  CONCLUSIONS
  Multidisciplinary restriction programs can reduce antibiotic consumption and Gram-negative resistance rates in the hospital setting.
authors: Fourth Department of Internal Medicine, University General Hospital Attikon, Greece.
authors: Anastasia
authors: A
authors: Antoniadou
authors: Kyriaki
authors: K
authors: Kanellakopoulou
authors: Maria
authors: M
authors: Kanellopoulou
authors: Michael
authors: M
authors: Polemis
authors: George
authors: G
authors: Koratzanis
authors: Evangelia
authors: E
authors: Papademetriou
authors: Garyfalia
authors: G
authors: Poulakou
authors: Efthimia
authors: E
authors: Giannitsioti
authors: Maria
authors: M
authors: Souli
authors: Alkiviadis
authors: A
authors: Vatopoulos
authors: Helen
authors: H
authors: Giamarellou
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization / Q000592:standards*; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D006761:Hospitals; D006801:Humans; D008826:Microbial Sensitivity Tests; D055656:Prescriptions / Q000592:standards* / Q000706:statistics & numerical data
chemical_list: D000900:Anti-Bacterial Agents