Usefulness of Computerized Restricted Antibiotics Use and Control Program in a Tertiary Care Hospital / 감염과화학요법

ABSTRACT

BACKGROUND: Excessive and inappropriate use of antimicrobial agents remains one of the most important factors affecting antibiotic resistance. We have developed the computerized control program for antibiotic use and evaluated utility of the program. MATERIALS AND METHODS: A computerized antibiotic control program was designed to restrict 15 antibiotics use, based on the mandatory approval by Infectious diseases specialists. The program was integrated into computerized order-entry system, and automatically stopped physician's antibiotics prescription in cases of no approval. We analyzed cases of disapproval on the restricted antibiotics use during the period from January to December, 2004 and evaluated the usefulness of the program. RESULTS: Total consumption of 15 restricted antibiotics out of whole antibiotics use was 14,457 (defined daily dose) DDD/144,692 DDD (9.99%). Total numbers of prescriptions for restricted antibiotics were 3,285:glycopeptides, 1,450 cases (44.1%); anti-pseudomonal cephalosporins, 699 cases (21.2%); carbapenem, 608 cases (18.5%). Three hundred eighty cases (11.65%) were not approved:'Inappropriate empirical use' was the most common with 34.5%. 'Unnecessary use' was 21.1% which included no evidence of infection, prophylactic use or long-term use. 'Incorrect regimen' as third reason (17.9%) means wrong choice of antibiotics due to misunderstanding of infection focus or organism. In addition, less expensive or more narrow-spectrum drugs were replaced in 17.6% of cases by infectious diseases specialists. CONCLUSIONS: A computerized antibiotic control program can improve inappropriate empirical antibiotic therapy and prevent unnecessary antibiotic use. It may contribute to make cost-effective mana gement and provide the better-quality of patient care.