EVOLUTION OF A METHOD TO COLLECT AND ANALYZE ANTIMICROBIAL PRESCRIBING DATA IN A UNITED-KINGDOM HOSPITAL

To identify the most suitable method to continuously monitor antibioti c prescriptions in a United Kingdom hospital, a study was performed in three phases over four years between 1985 and 1989 in a Liverpool tea ching hospital. The aim of the study was to perfect a method to collec t and analyse hospital-wide antibiotic prescribing data. The emphasis was laid on identifying problems and practicalities and also to minimi ze manpower and resource requirements. The data were used to illustrat e the effect of the hospital's antibiotic policy on prescribing trends . The policy recommendation that co-trimoxazole be substituted by trim ethoprim was only partially adhered to because Augmentin(R) was the ot her replacement antibiotic in a significant number of cases. Therefore , it is important to monitor the effects of target drug programmes on all antibiotics since certain sequelae may be unexpected. A total of 1 ,804, 2,526 and 3,226 antibiotic prescriptions were collected and anal ysed during phases I, II, and III respectively. 72-73% of the prescrip tions were for the treatment of infection which equated to 81-89% of t he total antibiotic cost. Therefore, cost control campaigns need to co ncentrate on infection treatment as apposed to prophylaxis. Specifical ly, respiratory tract, septicaemia and pyrexias of unknown origin acco unt for the bulk of antibiotic expenditure. The method for phases I an d II was multidisciplinary and very time-consuming. Phase III was very fast in operation, with data collection and analysis being performed on a single computer dedicated for the task. The minimum staff require d to monitor all antibiotic prescriptions is one full-time pharmacist and clerk. Continous intensive antibiotic monitoring in United Kingdom hospitals will not be feasible until antibiotic prescription forms ar e introduced on all wards.