IMPLEMENTATION OF A CRITERIA-BASED ANTIMICROBIAL FORMULARY SYSTEM

The development of a criteria-based antimicrobial formulary system for use in a 432-bed university-based tertiary-care hospital is described . A subcommittee of the hospital's pharmacy and therapeutics committee developed prescribing criteria for antimicrobials thought to have a s pecific place in the treatment of various infections. The criteria wer e based primarily on patient needs, but when two therapies were though t to have similar effectiveness and similar toxicity profiles, cost be came the deciding factor in drug selection. Educational packets were d esigned to assist physicians in prescribing criteria-based antimicrobi als. An antimicrobial order form was also developed. The program was i mplemented after an extensive orientation and education period; data o n antimicrobial use were collected for the first year of the program. Hospitalwide compliance with the criteria was 89%, although compliance in certain departments was poorer. The database was formulated to be both service- and physician-specific for the purposes of reporting and education.