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Hospital Usage of Parenteral Antimicrobial Agents: A Gradated Utilization Review and Cost Containment Program

Published online by Cambridge University Press:  02 January 2015

Lawrence L. Pelletier Jr
Lawrence L. Pelletier Jr*
Affiliation:
Medical Service, Wichita Veterans Administration Medical Center and Department of Internal Medicine, University of Kansas Medical School-Wichita, Kansas
*
Medical Service, Wichita VAMC, 5500 E Kellogg, Wichita, KS 67218
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Abstract

Forty percent to 60% of antimicrobial agents administered in hospitals without effective antimicrobial review and control programs are not needed. Excessive use of antimicrobial agents in the hospital promotes colonization of patients with resistant organisms, needlessly exposes them to the risk of an adverse drug reaction, and increases the cost of care. A gradated antimicrobial utilization review program is presented that determines hospital usage, develops guidelines for appropriate cost-effective drug administration, provides several options for implementation, and monitors outcome so that measures can be modified for specific situations. The techniques used are basic epidemiologic measures currently used to assess hospital infections.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 6 , Issue 6 , June 1985 , pp. 226 - 230
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1985

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References

1.Kunin, CM, Tupasi, T, Craig, WA: Use of antibiotics. Ann Intern Med 1973; 79:555–560.Google Scholar
2.Craig, WA, Uman, SJ, Shaw, WR, et al: Hospital use of antimicrobial drugs: Survey at 19 hospitals and results of antimicrobial control program. Ann Intern Med 1978; 89:793–795.Google Scholar
3.Roberts, AW, Visconti, JA: The rational and irrational use of systemic antimicrobial drugs. Am J Hosp Pharm 1972; 130:261–266.Google Scholar
4.Castle, M, Wilfert, CM, Cate, TR, et al: Antibiotic use at Duke University Medical Center. JAMA 1977; 237:2819–2822.Google Scholar
5.Scheckler, WE, Bennett, JV: Antibiotic usage in seven community hospitals. JAMA 1970; 213:264–267.CrossRefGoogle ScholarPubMed
6.Achong, MR, Theal, HK, Wook, J, et al: Changes in hospital antibiotic therapy after a quality-of-use study. Lancet 1977; 2:1118–1121.CrossRefGoogle ScholarPubMed
7.Kunin, CM: Antibiotic accountability. N Engl J Med 1979; 301:380–381.Google Scholar
8.Townsend, TR, Shapiro, M, Rosner, B, et al: Use of antimicrobial drugs in general hospitals. I. Description of population and definition of methods. J Infect Dis 1979; 139:688–697.Google Scholar
9.Shapiro, M, Townsend, RT, Rosner, B, et al: Use of antimicrobial drugs in general hospitals. II. Analysis of patterns of use. J Infect Dis 1979; 139:698–706.Google Scholar
10.Naqvi, SH, Dunkle, LM, Timmerman, KJ, et al: Antibiotic usage in a pediatric medical center. JAMA 1979; 242:1981–1984.CrossRefGoogle Scholar
11.Townsend, TS, Shapiro, M, Rosner, B, et al: Use of antimicrobial drugs in general hospitals: IV. Infants and children. Pediatrics 1979; 64:573–578.Google Scholar
12.Moss, FM, McNichol, MW, McSwiggan, DA, et al: Survey of antibiotic prescribing in a district general hospital. Lancet 1983; 128:349-352, 407–409.Google Scholar
13.Ma, MY, Goldstein, EJC, Friedman, MH, et al: Resistance of gram-negative bacilli as related to hospital use of antimicrobial agents. Antimicrob Agents Chemother 1983; 24:347–352.CrossRefGoogle ScholarPubMed
14.Durbin, WA, Lapidas, B, Goldmann, DA: Improved antibiotic usage following introduction of a novel prescription system. JAMA 1981; 246:1796–1800.Google Scholar
15.Hirschmann, JV, Inui, TS: Antimicrobial prophylaxis: A critique of recent trials. Rev Infect Dis 1980; 2:1–23.Google Scholar
16.Abramowicz, M (ed): Surgical prophylactic antimicrobials. Med Lett Drugs Ther 1983; 25:113–116.Google Scholar
17.VA ad hoc Committee on Antimicrobial Drug Usage: Guidelines for peer review. JAMA 1977; 237:1001-1008, 1134-1137, 1241-1245, 1366-1369, 1481-1484, 1605-1608, 1723-1725, 1859-1860, 1967–1970.Google Scholar
18.Henricks, J: Audit criteria for drug utilization review. American Society for Hospital Pharmacists, 1981, 2 vol.Google Scholar