[Use of antibiotics in a general hospital (author's transl)]

The utilization of antibiotics at a general hospital has been assessed by retrospectively studying the clinical histories of all patients admitted during the month of April 1978 to the Residencia General de la Ciudad Sanitaria Virgen de la Arrixaca (Murcia, Spain). Medical records were reviewed according to a preestablished protocol. Out of 1.057 patients admitted antibiotics were used in 419 (46%), of whom 189 belonged to the medical services and 302 to the surgical ones. Overall, the surgical services utilized more antibiotics and had less bacteriologic data on their patients. Antibiotics more utilized were ampicillin, which use was generally correct, followed by gentamicin, the G-penicillins, and trimethoprim-sulfamethoxazol. Undesirable side-effects of antibiotic treatment were found in 13 cases (2,6%). Infectious disease of bacterial origin was correctly diagnosed in 40% of the cases, while the diagnosis was doubtful or incorrect in the remaining 60% of cases treated with antibiotics. Appropriate bacteriological data were obtained only in 164 cases (33,4%), with positive results in 75 (49,9%). Independent antibiotics were given in association in 157 cases (31,9%). From this study it can be concluded that the more frequent causes of improper antibiotic utilization were the incorrect clinical diagnosis of bacterial infectious disease, the prophylactic use of antibiotics and the scarcity of bacteriological data. It is therefore suggested that systems of supervision of in-hospital antibiotic prescription be updated and continuous education programs for hospital staff be instituted.