title: Evaluation of the efficiency of hospital antibiotic policy applied Dr Jan Biziel University Hospital No 2 in Bydgoszcz in 2009-2013.
abstract: The Hospital Infection Control Team (HICT) of Dr Jan Biziel University Hospital No 2 in Bydgoszcz developed and implemented the principles of a rational antibiotic therapy in 2008. A behavior algorithm has worked since 01.10.2008. Implementation of the principles of a rational antibiotic therapy was part of the hospital antibiotic policy.
  
  
  OBJECTIVE
  is to evaluate either introductory principles of the rational antibiotic therapy, after five-year experience lived up to expectations in the range specified by the authors.
  
  
  METHODS
  Hospital microbiological maps, comparisons of antibiotic cost, specification of microbiological tests made before and after introduction of the principles of a rational antibiotic therapy have been analyzed. Annual antibiotic consumption has been counted according to the defined daily dose (DDD) index created by the WHO.
  
  
  RESULTS
  After 6 years of implementation of the rational antibiotic therapy principles, the decrease in number of isolated strains which are resistant to Klebsiella pneumoniae ESBL and Acinetobacter baumanii (resistant to carbapenems) has been indicated. The number of the Pseudomonas aeruginosa isolates has increased approximately three times, and the number of resistant isolates to carbapenem has grown six times. The cost of antibiotics has been gradually decreased in 2012 in order to represent 9,66% of all drug budget (without drug programs). Detailed analysis of antibiotic consumption has showed that after the implementation of rational antibiotic therapy principles the consumption of meropenem has increased twice in comparison to the all drugs. The number of microbiological tests grew from 0,20 to 0,29 per one patient, which means material to microbiological tests has been taken from every third patient. Annual DDD index calculated on 100 person-days has been reduced from 59,552 in 2007 to 39,90 in 2009, and it is 47,88 in 2013. The principles of rational antibiotic therapy in comparison with the other elements of antibiotic policy in hospital have caused positive changes in antibiotic ordinance.
  
  
  CONCLUSIONS
  1. It is required to adhere to the principles of a rational antibiotic therapy by medical staff mainly on the administrative restriction of access to antibiotics. 2. Monitoring changes in drug resistance of hospital flora is an essential element of the principles of a rational antibiotic therapy modification.
authors.affiliation: Jan Biziel University Hospital No 2 in Bydgoszcz.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Kuziemski
authors.affiliation: Jan Biziel University Hospital No 2 in Bydgoszcz.
authors.forename: Krystyna
authors.initials: K
authors.lastname: Frankowska
authors.affiliation: Jan Biziel University Hospital No 2 in Bydgoszcz.
authors.forename: Ewa
authors.initials: E
authors.lastname: Gonia
authors.affiliation: Jan Biziel University Hospital No 2 in Bydgoszcz.
authors.forename: Beata
authors.initials: B
authors.lastname: Czerniak
authors.affiliation: Jan Biziel University Hospital No 2 in Bydgoszcz.
authors.forename: Olena
authors.initials: O
authors.lastname: Bakhurynska
authors.affiliation: Jan Biziel University Hospital No 2 in Bydgoszcz.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Sobociński
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D004469:Economics, Hospital / Q000458:organization & administration; D017598:Efficiency, Organizational; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D011044:Poland; D058996:Quality Improvement / Q000191:economics / Q000458:organization & administration*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents