Use and misuse of antimicrobial agents in a general hospital in the AIDS era

Area of Science:

• Infectious Diseases
• Hospital Pharmacy
• Public Health

Background:

• Antimicrobial use, costs, and relevance were assessed in a general hospital during the Acquired Immunodeficiency Syndrome (AIDS) era.
• Understanding antimicrobial prescribing patterns is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

• To ascertain the pattern of antimicrobial use, associated costs, and relevance in a general hospital setting.
• To compare antimicrobial use adequacy between patients with and without HIV/AIDS.

Main Methods:

• A prevalence study involving all patients receiving antimicrobials.
• Categorization of antimicrobials into antibacterial drugs and others, with cost evaluation in US dollars.
• Analysis of treatment adequacy based on drug choice and patient population (HIV-positive vs. HIV-negative).

Main Results:

• Out of 1526 patients, 455 (29.8%) received 664 antimicrobial courses; 15% involved non-antibacterial drugs.
• Inadequate treatment occurred in 40.9% of treated patients, primarily due to incorrect drug selection.
• Patients with AIDS accounted for 9% of antimicrobial recipients and 19.7% of usage, but had better treatment adequacy (17% misuse) compared to non-HIV patients (43% misuse).

Conclusions:

• Despite a disproportionate antimicrobial burden, patients with AIDS demonstrated better antimicrobial use adequacy than their non-HIV counterparts.
• Incorrect drug choice was a significant factor in inadequate antimicrobial treatment across the hospital.
• Hospital antimicrobial stewardship programs should address both HIV-positive and HIV-negative patient populations, focusing on appropriate drug selection.