Impact of a multidisciplinary approach on antibiotic consumption, cost and microbial resistance in a Czech hospital

The study objective was to evaluate the impact of a restrictive antibiotic policy, efficacy of inpatient therapeutic and prophylactic antibiotic regimens and susceptibility patterns of infecting bacteria in 2000-2004. A 500-bed general hospital in the Czech Republic. A retrospective computerized survey of antibiotic prescribing practices over a five-year period 2000-2004, using medical records and laboratory data from the hospital information system (HIS). Consumption of antibiotics expressed in defined daily doses (DDDs) and Euros per 1,000 bed days. Resistance to antibiotics, average length of hospital stay, rate of inpatients treated with antibiotics, number of nosocomial infections per 1,000 bed days, median length of hospital stay and total mortality. Due to a restrictive antibiotic policy implemented in 2002, the use of several antibiotics in 2003 was significantly reduced but the consumption of several other antibiotics rose in 2003. In comparison with 2001 the cost of antibiotic agents (in Euro per 1,000 inpatient days) fell significantly by 31% in 2003 (969.07Euro vs. 671.34Euro). The hospital saved about 29,288Euro after the first year of implementation of the new antibiotic policy. The use of restricted antibiotics increased by 8%; however, the expenditure decreased by 26%. For non-restricted antibiotics, the use and expenditure decreased by 71% and 41%, respectively. Consequently, a net reduction of 55% (804.36Euro vs. 359.36Euro) was achieved. The intervention was effective in reducing the use and cost of antibiotics. The HIS is a helpful tool for observing and evaluating the impacts of the measures taken and can be used for assessment of pharmacotherapy outcomes.