Assuring rational antibiotic use: the impact of a joint microbiology-pharmacy surveillance program

A comprehensive antibiotic surveillance program conducted in cooperation with the Microbiology and Pharmacy departments in a teaching hospital is described. The program consists of a number of interrelated processes including the personal advice of specialists including a Clinical Microbiologist, Infection Control Nurse and Ward Pharmacists, re-educative strategies and non restrictive administrative policies. The program does not involve the use of formularies or published guidelines, and retains complete clinical freedom of choice for antibiotics. Studies, including antibiotic prevalence and prescribing surveys, indicate that the program has been an effective means of improving antibiotic use, reducing costs and promoting infection control. This has been achieved by educative means through the provision of relevant information on antibiotic principles, and opportunities for prescribers to improve their problem solving skills, resulting in long term attitudinal change.