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Drug information (i. Anti-infectives, ii. cytostatics, iii. others)
Management of restricted antibiotics
  1. G. Arslan
  1. 1American Hospital, Pharmacy, Istanbul, Turkey

Abstract

Background Attempts are made worldwide to restrict and control antibiotics because of rising concern about problems of antibiotic resistance.

Purpose The purpose of this research was to develop policies and guidelines for the process of prescribing antibiotics to determine the patients who use restricted antibiotics and plan their treatment.

Materials and methods Last year, a multidisciplinary subcommittee was constructed of members of the infection control committee. The committee first listed the restricted antibiotics in the hospital formulary and found this added up to 13% of all drugs in the list. It was decided to enlist the benefits of technology. ‘Pyxis drug consoles’ were programmed to provide a batch report which lists all the patients who use restricted antibiotics and the pharmacy sends these lists to the email group of the infection control committee every morning. A special investigator group was created in 2011 that consisted of an infection doctor, an infection nurse, a pharmacist and a microbiologist. An ‘antibiotic usage form’ was created by the group and filled in for each patient for one month. All patients who used antibiotics were visited three times a week and data were collected from their charts.

Results After visits, evidence of 552 occasions of antibiotic usage was collected and evaluated via the STATA program. The authors noticed that 45% of administrations were inconvenient during treatment, 62% inconvenient usage in prophylaxis. The causes of inconvenient usage of restricted antibiotics in prophylaxis; 63% reported it was ‘unnecessary’, 6% said it was ‘completely unnecessary’, 3% ‘too broad a spectrum antibiotic’ was used, 2% insufficient spectrum antibiotic. In empiric administration; 33% was completely unnecessary, 10% stringing it out was unneccesary, 9% too broad spectrum, 7% insufficient antibiotic spectrum.

Conclusions The list of antibiotics that were being used inappropriately was determined and classified according to the department using them. The multidisciplinary approach has increased the awareness of the healthcare professionals of the antibiotic resistance problem.

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