Cost‐Effective Antibiotic Prescribing

Gleckman, Richard A.; Gantz, Nelson M.

doi:10.1002/j.1875-9114.1983.tb03264.x

Cited by 16 publications

(1 citation statement)

References 51 publications

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“…Unfortunately, educational programs alone do not seem to have the desired effect (16), whereas improved results have been reported with restrictive policies such as those that require written justification by the prescribing physician (17,18). We felt that the best results would be obtained by combining education with facilitative and restrictive methods.…”

Section: Discussionmentioning

confidence: 99%

A Multidisciplinary Hospital‐based Antimicrobial Use Program: Impact on Hospital Pharmacy Expenditures and Drug Use

Salama

Rotstein

Mandell

1995

Canadian Journal of Infectious Diseases and Medical Microbiolog

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The authors' hospital embarked on a three-component, multidisciplinary, hospital-based antimicrobial use program to cut costs and reduce inappropriate antimicrobial use. Initially, antimicrobial use patterns and costs were monitored for 12 months. For the next two years, an antimicrobial use program was implemented consisting of three strategies: automatic therapeutic interchanges; antimicrobial restriction policies; and parenteral to oral conversion. The program resulted in a reduction in the antimicrobial portion of the total pharmacy drug budget from 41.6% to 28.2%. Simultaneously, the average cost per dose per patient day dropped from $11.88 in 1991 to $10.16 in 1994. Overall, mean monthly acquisition cost savings rose from $6,810 in 1992 to $27,590 in 1994. This study demonstrates that a multidisciplinary antimicrobial use program in a Canadian hospital can effect dramatic cost savings and serve as a quality assurance activity of physician antimicrobial prescribing behaviour. Key Words: Antibiotic use program, Hospital expenditureProgramme hospitalier pluridisciplinaire d'antibiothérapie : impact sur les dépenses de la pharmacie de l'hôpital et sur l'emploi des médicaments RÉSUMÉ : L'établissement des auteurs a amorcé un programme hospitalier pluridisciplinaire d'antibiothérapie en trois volets afin de réduire les coûts et de prévenir l'emploi inapproprié des antibiotiques. Au départ, les modes d'utilisation des antibiotiques et les coûts ont été surveillés pendant 12 mois. Pendant les deux années suivantes, un programme d'antibiothérapie comportant trois stratégies a été mis en application : substitution thérapeutique automatique, politique de restriction des antibiotiques et conversion de la voie parentérale à la voie orale. Le programme a entraîné une réduction de la portion antimicrobienne du budget total de la pharmacie en terme de médicaments, soit de 41,6 % à 28,2 %. Simultanément, le coût moyen par dose par patient a chuté de 11,88 $ en 1991 à 10,96 $ en 1994. De façon globale, les économies en matière de coût mensuel d'acquisition se sont élevées de 6 810 $ en 1992 à 27 590 $ en 1994. Cette étude démontre qu'un programme d'utilisation pluridisciplinaire des antibiotiques dans un hôpital canadien peut amener des économies considérables en terme de coûts et servir de mesure d'assurance de la qualité lorsqu'il est question des habitudes d'ordonnance des médecins en matière d'antibiothérapie. 104CAN J INFECT DIS VOL 7 NO 2 MARCH/APRIL1996

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Section: Discussionmentioning

confidence: 99%

A Multidisciplinary Hospital‐based Antimicrobial Use Program: Impact on Hospital Pharmacy Expenditures and Drug Use

Salama

Rotstein

Mandell

1995

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Can Fluoroquinolones Be Considered Once‐Daily Therapy?

Neu

1992

The Journal of Clinical Pharma

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Fluoroquinolone antimicrobial agents inhibit most Enterobacteriaceae at extremely low concentrations, less than or equal to 0.5 microgram/mL. The half-lives of the agents range from 4 to 18 hours. Most of the available fluoroquinolones can be administered once daily to treat urinary tract and diarrheal infections. Newer agents with long half-lives that inhibit gram positive organisms at lower concentrations than the older fluoroquinolones, less than or equal to 1 microgram/mL, and have a long post-antibiotic effect have the potential to be used once daily as treatment of respiratory, skin-structure and selected bone infections as well. Careful clinical studies are needed to establish the efficacy of once daily use of fluoroquinolones, to determine that clinical efficacy is equivalent to multiple doses, and that once-daily dosing does not select more resistant bacteria. Single-dose therapy with quinolones would be an improvement in cost and patient compliance.

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Antibiotic Irrigations A Plea for Controlled Clinical Trials

et al. 1985

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Although the medical literature describes the perioperative use of antibiotic irrigations in abdominal, pelvic, orthopedic and vascular surgery, the lack of well-designed and executed, controlled clinical studies often precludes a definitive assessment of the value of this technique. Future randomized, double-blind, controlled clinical trials are required to establish its merit. In this age of cost consciousness, lavages with antibiotic solutions cannot at present be regarded as conventional medical therapy.

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Cost‐Effective Antibiotic Prescribing

Cited by 16 publications

References 51 publications

A Multidisciplinary Hospital‐based Antimicrobial Use Program: Impact on Hospital Pharmacy Expenditures and Drug Use

A Multidisciplinary Hospital‐based Antimicrobial Use Program: Impact on Hospital Pharmacy Expenditures and Drug Use

Can Fluoroquinolones Be Considered Once‐Daily Therapy?

Antibiotic Irrigations A Plea for Controlled Clinical Trials

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