Hospital antibiotic policy in a health district

Area of Science:

• Hospital Pharmacy
• Infectious Disease Management
• Antimicrobial Stewardship

Background:

• Hospital antibiotic policies are crucial for controlling antimicrobial resistance and healthcare costs.
• Restricted antibiotic formularies can impact consumption patterns and resistance levels.
• Previous studies highlight the need for effective strategies to manage antibiotic use in clinical settings.

Purpose of the Study:

• To evaluate the impact of a restricted hospital antibiotic policy on antibiotic consumption, costs, and resistance.
• To assess the occurrence of cross-infection epidemics during the policy implementation.
• To analyze the specific antibiotics used and their associated resistance patterns.

Main Methods:

• Implementation of a hospital-wide antibiotic policy restricting the number of prescribed agents over a two-year period.
• Monitoring antibiotic consumption, focusing on six key antibiotics that constituted 98% of usage.
• Surveillance of antibiotic resistance in key bacterial pathogens (Staphylococcus aureus, Enterobacteriaceae, Bacteroides) and tracking cross-infection rates.

Main Results:

• Antibiotic consumption and total costs decreased substantially from 1976 to 1978.
• High resistance rates to ampicillin were observed in Staphylococcus aureus (80%), Enterobacteriaceae (37%), and Bacteroides (83%).
• No major epidemics of cross-infection were reported during the study period.

Conclusions:

• A restricted antibiotic policy can effectively reduce antibiotic consumption and associated costs.
• Careful selection of antibiotics within a policy can maintain clinical efficacy while managing resistance.
• The policy demonstrated success in preventing widespread infections and controlling healthcare expenditure.