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Pharmacy World and Science

, Volume 17, Issue 5, pp 163–167 | Cite as

Improving the quality of antimicrobial drug use can result in cost containment

  • Inge C. Gyssens
  • Bart Jan Kullberg
Practice/Case Reports

Abstract

Antibiotic policies are implemented to optimize patient care, to limit antimicrobial resistance and to reduce costs. Before improving the use of antimicrobial drugs by monitoring, it is of primary importance to conduct a general utilization review to document problem areas within the hospital and to evaluate quality and costs. Subsequently, limited targets for an intervention can be defined. For the evaluation of quality, established criteria can be used to classify prescriptions into categories of appropriate use. Several classification systems are described in the literature. We have developed a classification method which allows evaluation of each relevant parameter associated with antimicrobial drug use and global (true) cost calculation. Data are processed in a computer program for Apple or Windows. Surgical prophylaxis is a target of choice to analyse at a hospital pharmacy level. Important cost savings can be obtained by implementing well-accepted standards of good antimicrobial prophylaxis.

Keywords

Antibiotics Cost control Costs & cost analysis Drug utilization Hospitals Quality control Surgery 

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References

  1. 1.
    Hekster YA, Barrett CW. Formulary antibiotic surveillance program. J Clin Pharm 1987;6:335–42.Google Scholar
  2. 2.
    Kunin CM. Use of antibiotics: a brief exposition of the problem and some tentative solutions. Ann Intern Med 1973;79:555–60.PubMedGoogle Scholar
  3. 3.
    Polk RE. The role of the infectious diseases physician in monitoring antimicrobial use: a pharmacy perspective. Bull NY Acad Med 1987;63:612–26.Google Scholar
  4. 4.
    Aswapokee N, Vaithayapichet S, Heller RF. Pattern of antibiotic use in medical wards of a university hospital, Bangkok, Thailand. Rev Infect Dis 1990;12:136–41.PubMedGoogle Scholar
  5. 5.
    Jones SR, Barks J. The effect of an educational program upon hospital antibiotic use. Am J Med Sci 1977;273:79–85.PubMedGoogle Scholar
  6. 6.
    Volger BW, Ross MB, Brunetti HR, Baumgartner DD, Therasse DG. Compliance with a restricted antimicrobial agent policy in a university hospital. Am J Hosp Pharm 1988;45:1540–4.PubMedGoogle Scholar
  7. 7.
    Dunagan WC, Woodward RS, Medoff G, Gray JL III, Casabar E, Smith MD, et al. Antimicrobial misuse in patients with positive blood cultures. Am J Med 1989;87:253–9.PubMedGoogle Scholar
  8. 8.
    Maki DG, Schuna AA. A study of antimicrobial misuse in a university hospital. Am J Med Sci 1978;275:271–82.PubMedGoogle Scholar
  9. 9.
    Woodward RS, Medoff G, Smith MD, Gray JL. Antibiotic cost savings from formulary restrictions and physician monitoring in a medical-school-affiliated hospital. Am J Med 1987;83:817–23.PubMedGoogle Scholar
  10. 10.
    Achong MR, Wood J, Theal HK, Goldberg R, Thompson DA. Changes in hospital antibiotic therapy after a quality-of-use study. Lancet 1977;2:1118–22.PubMedGoogle Scholar
  11. 11.
    Pelletier LL Jr. Hospital usage of parenteral antimicrobial agents: a gradated utilization review and cost containment program. Infect Control 1985;6(6):226–30.PubMedGoogle Scholar
  12. 12.
    Gyssens IC, van den Broek PJ, Kullberg BJ, Hekster YA, van der Meer JWM. Optimizing antimicrobial therapy. A method for antimicrobial drug evaluation. J Antimicrob Chemother 1992;30:724–7.PubMedGoogle Scholar
  13. 13.
    Moss F, McNicol MW, McSwiggan DA, Miller DL. Survey of antibiotic prescribing in a district general hospital I. Pattern of use. Lancet 1981;2:349–52.PubMedGoogle Scholar
  14. 14.
    Quintiliani R, Nightingale CH, Crowe HM, Cooper BW, Bartlett RC, Gousse G. Strategic antibiotic decision-making at the formulary level. Rev Inf Dis 1991;13 Suppl 9:S770–7.Google Scholar
  15. 15.
    Gladen HE. Computer modelling antibiotic therapy costs. Impact of therapeutic range. Drugs 1988;35 Suppl 2:208–13.PubMedGoogle Scholar
  16. 16.
    Gyssens IC, Lennards CA, Hekster YA, van der Meer JWM. The cost of antimicrobial chemotherapy. A method for cost evaluation. Pharm Weekbl Sci 1991;13(6):248–53.PubMedGoogle Scholar
  17. 17.
    Anatomical Therapeutic Chemical (ATC) classification index, including defined daily doses (DDDs) for plain substances. Oslo: WHO Collaborating Centre for Drug Statistics Methodology, 1993.Google Scholar
  18. 18.
    Hekster YA, Vree TB, Goris RJA, Boerema JBJ. The defined daily dose per 100 bed days as a unit of comparison and parameter for studying antimicrobial drug use in a university hospital. J Clin Hosp Pharm 1982;7:251–60.PubMedGoogle Scholar
  19. 19.
    Dellinger EP, Gross PA, Barrett TA, Krause PJ, Martone WJ, McGowan JE, et al. Quality standard for antimicrobial prophylaxis in surgical procedures. Infect Control Hosp Epidemiol 1994;15:182–8.PubMedGoogle Scholar

Copyright information

© Royal Dutch Association for Advancement of Pharmacy 1995

Authors and Affiliations

  • Inge C. Gyssens
    • 1
    • 2
  • Bart Jan Kullberg
    • 1
  1. 1.Department of General Internal MedicineUniversity Hospital NijmegenHB Nijmegenthe Netherlands
  2. 2.Department of Clinical MicrobiologyUniversity Hospital RotterdamGD Rotterdamthe Netherlands

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