Survey on Prescribing of Antimicrobial Agents (AA) in University Hospital in Two Consecutive Years

Over prescribing of antimicrobial agents (AA) is generally regarded as one of the major causes of growing resistance both in outpatient and hospital setting. In attempt to improve prescribing of AA in our hospital we did a survey of prescribing of AA in our hospital. In 2001 and 2002 during one day all the patients hospitalized were seen by clinical pharmacologists and checked for AA therapy. On Feb 21st 2001 216 out of 714 patients (30.3%) and on OCT 23rd 2002 207 out of 891 (23.2%) were receiving AA. On both occasions gentamycin and cefuroxime were mostly prescribed AA representing nearly 25% of total AA prescribed. To determine whether AA were used appropriately a scoring system was used. Out of 243 courses of AA treatment 86 were restricted release antimicrobials in 2001 and 77/273 in 2002. According to the robust scoring system in 2001 AA were properly used in 104 out of 138 pts for treatment (prophylactic use excluded) and in 2002 AA were properly used in 113 out of 149 pts. Questionable use of AA was very similar, 24% in both years. The results of the survey are the basis for the measures to be proposed by Hospital Drug Committee to improve AA prescribing in our Hospital. Taking into account that 25% of total drug bill goes to AA optimizing of prescribing or diminishing even a part of unnecessary use of AA could save substantial amount of money not to speak about medical aspects of rational use of AA in the hospital.