Antimicrobial drug use in the department of internal medicine of a general hospital: prevalence study

Abstract

Objective. To ascertain the general pattern of hospital antimicrobial use, costs, and adequacy of treatment in the department of internal medicine of a general hospital. Material and methods. A prevalence study was carried out and all department beds were visited. Every patient who was being treated with antimicrobials during or 24 hours prior to the visit was selected for the study. Treatment was considered adequate when indication, selected drug, dosage, and treatment duration were all adequate. When considering costs, only the price of the antimicrobials was evaluated. Results. We identify 173 hospitalized patients, 79 (45.6%) of them were treated with 96 antimicrobial agents. The prevalence of community-acquired and hospital-acquired infections was 39.3% and 8.1%, respectively. Empirical use amounted to 77%. Overall, b-lactams antibiotics were the most frequently used (63.5%). In 22 (27.8%) patients treatment was judged inadequate, the most frequent error being an excesive duration (17.8%). The daily spending on antimicrobials was 187,750 ptas., representing 1,085 ptas. per hospitalized patient and day. Conclusions. A high percentaje of hospitalized patients receive treatment with antimicrobial drugs. Because of the low rate of antimicrobials with a specific indication, the long antibiotic course duration, the incorrect drug choice, and even more the antimicrobial prescription in non-infected patients, strategies to improve the quality of antimicrobial use are clearly required.