Compliance and Impact of an ID Physician's Advisory Consults on the Use of Restricted Antimicrobial Agents

Kim, Baek Nam; Jin, Kyu Bok; Hong, Yoon Seok

Abstract

BACKGROUND: Many strategies have been developed to guide more appropriate and cost-effective antibiotic use in hospitals. This study was done to evaluate compliance and short-term impact of targeted antibiotic advisory consult implemented in our hospital since October 2002.
Materials and METHODS
A total of 339 prescriptions in 187 patients were retrospectively reviewed and antimicrobial utilization density was compared quarterly from January 2002 through June 2003.
RESULTS
Overall, 85.6% of prescriptions were inappropriate, with 73.7% being inappropriate for therapeutic regimens and 100% for prophylactic regimens. Overall compliance was 46.5%. The compliance was higher in the medical services than in the surgical services (64.2% vs. 43.1%, P=0.005) and for therapeutic use than for prophylactic use (54.7% vs. 36.5%, P=0.001). From 1Q 2002 to 2Q 2003, use of aminoglycosides was reduced from 269.1 AUD to 171.8 AUD, and that for antipseudomonal cephalosporins from 112.1 AUD to 64.5 AUD (both, P<0.01). Overall, inpatient use of parenteral antibiotics was decreased from 770.8 AUD to 626.8 AUD (P<0.01).
CONCLUSION
Targeted antibiotic advisory consult resulted in substantial reduction in antibiotic use despite relatively poor compliance. This type of antibiotic control program can be an alternative for hospitals with limited human resources trying to implement an antibiotic policy.