Pharmacy World and Science

, Volume 18, Issue 4, pp 137–141 | Cite as

Feasibility of an antibiotic order form. First experience in the department of internal medicine of a university hospital

  • Willem L. Blok
  • Inge C. Gyssens
  • Yechiel A. Hekster
  • Peter P. Koopmans
  • Jos W. M. van der Meer


Inadequate control of antimicrobial drug use may lead to excessive expenditure for antimicrobial drugs and improper prescribing. It may also result in the emergence of multiresistant bacteria. An antibiotic order form may improve the quality of prescriptions by increasing the awareness of the physician of the antimicrobial spectrum needed (i.e. which microorganism is expected in a given patient), the desired duration of treatment, the potential need to adjust dosage, and the potential allergy of the patient to the drug. Furthermore, such an antibiotic order form facilitates prospective evaluation of both the quantity and the quality of prescribing practice. However, the introduction of yet another form to fill in may be met with opposition from prescribers. We have developed an easy-to-use antibiotic order form that incorporated the conventional medication order that was already in use in our hospital. Compliance (percentage of antimicrobial drug prescriptions for which an order form was used) was on average 58% in the first two weeks after introduction, and remained thereafter between 60% and 90%, varying between the different wards. Data retrieved from the antibiotic order forms could be used for surveillance. We conclude that this antibiotic order form was feasible in a large department of internal medicine of a university hospital. Future usefulness will depend on compliance and on personnel support for data processing and intervention.


Antibiotics Antibiotic policy Hospital Order form Pharmacy Pharmacoepidemiology Prescription 


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  1. 1.
    Mouton RP, Glerum JH, VanLoenen AC. Relationship between antibiotic consumption and frequence of antibiotic resistance of four pathogens — a seven year study. J Antimicrob Chemother 1976;2:9–19.Google Scholar
  2. 2.
    Goossens H, VanLaethem Y, Levy J, et al. Predicting gentamicin resistance from annual usage in hospital. Lancet 1986;ii:804–805.Google Scholar
  3. 3.
    Quintiliani R. Strategies for the cost-effective use of antibiotics. In: Gorbach SL, Bartlett JG, Blacklow NR (eds.) Infectious Diseases Philadelphia: W.B., Saunders Company, 1992: 348–352.Google Scholar
  4. 4.
    Durbin WAJ, Lapidas B, Goldmann DA. Improved antibiotic usage following introduction of a novel prescription system. JAMA 1981;246:1796–1800.Google Scholar
  5. 5.
    Kowaisky SF, Echols RM, Peck FJr. Preprinted order sheet to enhance antibiotic prescribing and surveillance. Am J Hosp Pharm 1982;39:1528–1529.Google Scholar
  6. 6.
    Schaffner W, Ray WA, Federspiel CF, Miller WO. Improving antibiotic prescribing in office practice: a controlled trial of three educational methods. JAMA 1983;250:1728–1732.Google Scholar
  7. 7.
    Echols RM, Kowalsky SF. The use of an antibiotic order form for antibiotic utilization review: influence on physicians' prescribing patterns. J Inf Dis 1984; 150 (dec):803–807.Google Scholar
  8. 8.
    8.Scarafile PD, Campbell BD, Kilroy JE, Methewson HO. Computer-assisted concurrent antibiotic review in a community hospital. Am J Hosp Pharm 1985;42:313–315.Google Scholar
  9. 9.
    Avorn J, Soumerai SB, Taylor W, Wessels MR, Janousek J, Weiner M. Reduction of incorrect antibiotic dosing through a structured educational order form. Arch Intern Med 1988;148:1720–1724.Google Scholar
  10. 10.
    Russell WA. Implementation of an antibiotic order form. Fl J Hosp Pharm 1988;8:337–349.Google Scholar
  11. 11.
    Todd MW, Keith TD, Foster MTJr. Development and implementation of acomprehensive criteria-based drug-use review program. Am J Hosp Pharm 1987;44:529–535.Google Scholar
  12. 12.
    Lipsy RJ, Smith GH, Maloney ME. Design, implementation, and use of a new antimicrobial order form: a descriptive report. Ann Pharmacother 1993;27:856–861.Google Scholar
  13. 13.
    Hess DA, Mahoney CD, Johnson PN, Corrao WM, Fisher AE. Integration of clinical and administrative strategies to reduce expenditures for antimicrobial agents. Am J Hosp Pharm 1990;47:585–591.Google Scholar
  14. 14.
    Coleman RW Rodondi LC, Kaubisch S, Granzella NB, O'Hanley PD. Cost-effectiveness of prospective and continuous parenteral antibiotic control: experience at the Palo Alto Veterans Affairs Medical Center from 1987 to 1989. Am J Med 1991;90:439–444.Google Scholar
  15. 15.
    Jeffrey LP, Mahoney CD. A comprehensive system for antimicrobial monitoring and review using a mandatory antimicrobial ordering sheet. Hosp Pharm 1987;22:877–883.Google Scholar
  16. 16.
    Moss F, McNicol MW, McSwiggan DA, Miller DL. Survey of antibiotic prescribing in a district general hospital. I. Pattern of use. Lancet 1981;ii:349–352.Google Scholar

Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Willem L. Blok
    • 1
  • Inge C. Gyssens
    • 3
  • Yechiel A. Hekster
    • 2
  • Peter P. Koopmans
    • 1
  • Jos W. M. van der Meer
    • 1
  1. 1.Department of General Internal MedicineUniversity Hospital NijmegenNijmegenThe Netherlands
  2. 2.Department of Clinical PharmacyUniversity Hospital NijmegenNijmegenThe Netherlands
  3. 3.Department of Clinical MicrobiologyUniversity Hospital RotterdamRotterdamThe Netherlands

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