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A decade of antibiotic use in a teaching hospital
P M Raymond1, M B Robertson, M L Mashford
1Department of Clinical Pharmacology, St Vincent's Hospital, Fitzroy, VIC.
Abstract:
A survey of the antibiotic agents that are being prescribed for inpatients in St Vincent's Hospital, Melbourne, has been carried out annually since 1976. This article describes the patterns of prescribing that were observed between 1976 and 1986 with special emphasis on the results since 1980, which was the year before the adoption of the hospital's antibiotic policy. The proportion of hospital inpatients who received antibiotic therapy as determined by prevalence studies varied from 25%-36%. Since the introduction of the antibiotic policy, 61%-70% of antibiotic courses were administered for the treatment of infection and 30%-39% of the courses were administered as prophylaxis. Amoxycillin and ampicillin were prescribed most frequently, followed by the cephalosporin agents and the other penicillins. In the area of the empirical treatment of infection, compliance with the hospital antibiotic policy improved and reached 76% of courses in 1986. In the area of prophylaxis, compliance improved a little and stood at 21% of courses in 1986.
Insights
This study tracked antibiotic prescribing at St Vincent's Hospital from 1976-1986. An antibiotic policy improved compliance for infection treatment but had less impact on prophylaxis.
Area of Science:
- Infectious Diseases
- Pharmacology
- Hospital Pharmacy
Background:
- Annual surveys of inpatient antibiotic prescribing at St Vincent's Hospital, Melbourne, have been conducted since 1976.
- This analysis focuses on prescribing patterns from 1976 to 1986, with emphasis on the period after the 1980 implementation of a hospital antibiotic policy.
Purpose of the Study:
- To describe antibiotic prescribing patterns in a hospital setting over a decade.
- To evaluate the impact of a hospital antibiotic policy on prescribing practices for both infection treatment and prophylaxis.
Main Methods:
- Prevalence studies were used to determine the proportion of inpatients receiving antibiotic therapy.
- Antibiotic prescribing data were analyzed annually from 1976 to 1986.
- Prescribing patterns were assessed for treatment of infection versus prophylactic use.
Main Results:
- The proportion of inpatients receiving antibiotics ranged from 25% to 36%.
- Following the antibiotic policy, 61%-70% of antibiotic courses were for infection treatment, and 30%-39% for prophylaxis.
- Amoxycillin and ampicillin were the most frequently prescribed antibiotics.
- Compliance with the antibiotic policy for empirical infection treatment improved significantly, reaching 76% by 1986.
- Compliance for prophylactic antibiotic use showed a smaller improvement, reaching 21% by 1986.
Conclusions:
- The hospital antibiotic policy demonstrated effectiveness in improving compliance for antibiotic use in treating infections.
- The policy had a less pronounced effect on the appropriate use of prophylactic antibiotics.
- Continued monitoring and potential refinement of the policy may be necessary to optimize prophylactic antibiotic prescribing.