ANALYSIS AND IMPACT OF INFECTIOUS-DISEASE CONSULTATIONS IN A GENERAL-HOSPITAL

During an 18-month period, data from all patients in whose care our in fectious diseases (ID) service was involved, were recorded in a comput erized database. A total of 4184 new consultations was recorded. The c onsultations were solicited by the patients' physicians in 3326 cases (80%) and initiated by the ID service in the remainder. The purpose of the consultations was diagnosis (14%), therapy (39%), both diagnosis and therapy (40%), and prophylaxis (6%). Two thousand and ninety-four consultations (50%) were performed at the bedside, and the others by p ersonal or telephone discussion. ID consultation was given in more tha n 10% of admitted patients in six departments, 46% of the admissions i n the ICU, and 6.9/100 hospitalized patients. Recommendations included : antibiotic manipulation (i.e., initiation, change or discontinuation of antibiotic treatment) (51%); performance of tests (13%); performan ce of diagnostic or therapeutic procedures (5%); prophylaxis (4%) or n o change in management (26%). Analysis of the solicited vs unsolicited consultations and of the bedside vs telephone consultations revealed that sub-groups of consultations differ significantly from each other in many aspects. Recording of consultations enables the ID service to evaluate its activity and to direct efforts to departments with high r ates of infectious diseases and/or antimicrobial usage.