Short-term impact of systematic infectiology consultation on antibiotic use in an intensive care unit

OBJECTIVES: Multiresistant bacteria are regularly isolated in nosocomial in fections occurring in intensive care units due to wide use of antibiotics. We evaluated the impact of systematic infectiology consultations on the qua lity of antibiotic prescriptions in an intensive care unit PATIENTS AND METHODS: Infectiology consultations (3 per week) were initiate d mid February 1999. The infectiologist gave oral advice to be implemented (or not) by the intensive care unit according to ongoing therapeutic option s. The hospital pharmacy recorded antibiotic use for March and April 1999 f or comparison with use recorded in 1998 for a similar period. We retrospect ively reviewed the flies of patients hospitalized during these periods and who had received antibiotics to determine the modalities of antibiotic use. The 4 antibiotics used for the longest period for each patient were record ed. RESULTS: Thirty-one patients in 1999 and 30 in 1998 were given antibiotics. The SAPS score was similar for the two groups. Mean duration of antibiotic treatment was lower during the March-April 1999 period than during the cor responding period in 1998: 13 +/- 9 days/patient versus 23 +/- 21 days/pati ent respectively, p = 0.037 In 1998, there were 596 antibiotic-days and in 1999 there were 455 (-24%). The cost of antibiotic therapy in 1998 was 70 3 42 FrF compared with 56 804 FrF in 1999 (-19%). CONCLUSION: Infectiology consultation, in association with the opinion of t he intensive care physician, is a simple way to limit antibiotic use. (C) 2 000, Masson, Paris.