INFLUENCING ANTIBIOTIC USE IN A MEDICAL C LINIC

The most costly drug interventions in hospitals are in the treatment o f infectious diseases. To improve the cost-effective use of antibiotic drugs it is necessary to consider rational indications, appropriate a dministration (sequential therapy) and control of antimicrobial resist ance. To obtain more information about prescribing habits, antibiotic prescription forms were collected prospectively over a six-month perio d in the Clinic of Internal Medicine at the Cantonal Hospital of Aarau . The influence of this new prescription form on antibiotic use, inclu ding the indication for therapy, was analyzed and compared with the re sults of a similar study done in 1994. The results showed use of a wid e variety of different antibiotics for the same indication, prevalence of intravenous administration, and widespread use of new and expensiv e antibiotics. The total cost of antibiotics was not reduced compared with the previous period. The characteristics of antibiotic use were e asily analyzed with minimal additional effort. With such data, specifi c actions for quality improvement in antibiotic use can be taken throu gh a multidisciplinary educational approach with regular instruction o n therapy guidelines, definition of first-line agents, information on the advantages of sequential therapy, and periodic reevaluation.