Antimicrobial use in a small rural hospital

An audit was done to determine the pattern of antimicrobial use in a small rural Canadian hospital. Over a three-month period, 85 (33.7%) of 252 hospitalized patients received systemic antimicrobials. The group comprised 19 children and 66 adults. Respiratory infections were most common in both children and adults, and ampicillin/amoxicillin was the most frequently used agent. Treatment was judged to be appropriate in all the children, but was inappropriate in 15% of the adults. Adults who had superficial skin infections, and urinary tract infections with catheters in place, were most often inappropriately treated with systemic antimicrobials. The causes of inappropriate antimicrobial use and how to prevent it are discussed.