Antibiotic guidelines lead to reductions in the use and cost of antibiotics in a university hospital

The object of this study was to improve the use of antibiotics at Aker Univ ersity Hospital, a 600-bed university hospital. We developed and implemente d guidelines for antibiotic treatment and prophylaxis. We describe the impa ct of these guidelines on the use and cost of antibiotics and evaluate comp liance with the guidelines. From 1994 to 1996 there mas an 11% reduction in the use of antibacterial agents and a 42% reduction in the use of antifung al agents. The use of broad-spectrum antibiotics was reduced by 23%. The us e of penicillin V and G increased by 5%, dikloxacillin/kloxacillin by 46% a nd erythromycin by 33%. Compared with 1994 values there mas a 27% reduction in antibiotic costs in 1995, amounting to USS 319,300, and a 32% reduction in antibiotic costs in 1996, amounting to US$ 380,000. A point-prevalence investigation conducted 18 months after the introduction of the guidelines indicated that compliance was >95%. it proved possible to reduce the use of broad-spectrum antibacterial and antifungal agents, with significant cost savings. Point-prevalence studies may be a useful tool to detect deviations from guidelines and provide physicians with educational feedback.