[Analysis of antibiotic use based on case histories]

Type and dose of antibiotics, length and purpose of therapy was retrospectively collected from case histories of the 2230 patients who were discharged from a district general hospital between January 1 and 31, 1995. The suitability of each antibiotic for its stated purpose was compared with the current therapeutic recommendations, guidelines and literature. 24.6% of patients received antibiotics. 83.9% of the 728 courses was monotherapy, 16.1% was combined therapy. 82.7% of the 852 prescriptions was empiric, 7.5% directed against an identified microorganism and 9.8% was prophylactic. 596 microbiological samples of 272 (49.5%) patients were sent to the laboratory. Infections of lower and upper airways, urinary tracts, wounds and abdominal organs were most frequently diagnosed. Majority of utilized antibiotics were broad spectrum beta lactams. 5.3% of patients suffered from hospital acquired infections. 23.8% of prescriptions were determined as unnecessary. Problems of inappropriate antibacterial spectrum (11.0% of prescriptions), negligence of pharmacokinetics (6.1%), long duration of therapy (7.2%) and underdosing (6.1%) were also frequent. Authors emphasize the importance of the monitoring drug utilisation, the introduction of hospital diagnostic and therapeutic protocols in order to improve the antibiotic usage.