Hospital antibiotic control measures in the UK. Working Party of the British Society for Antimicrobial Chemotherapy.

Abstract

In 1990 374 consultant microbiologists and 733 hospital pharmacists nationwide were sent a questionnaire on methods used to control antibiotic usage. Forty-nine per cent were returned. Attempts to control usage are widespread. A written policy for surgical prophylaxis was available in 51% of hospitals, 62% had a policy for therapy and 79% an antibiotic formulary. The policies for prophylaxis and therapy both gave recommendations on individual drugs in 95% of hospitals, on dosage in 81% and 60% and duration of prophylaxis/treatment in 90% and 51% respectively. Compliance was monitored in approximately 40%, and steps were taken in half to control non-compliance. Eighty-eight per cent believed policies for prophylaxis and therapy to be beneficial. A restricted list was operated in 77% of hospitals and 90% of respondents believed formularies to be beneficial. Fifty-two per cent of respondents claimed educational campaigns were used. These were 'occasional' in frequency in 79% and were most commonly based on information sheets. Fifty per cent of respondents had cost-control campaigns, 26% automatic stop dates on prescriptions and 43% automatic therapeutic substitution. Eleven per cent had antibiotic utilization co-ordinators, 86% of hospitals had a Pharmacy and Therapeutics Committee, and 17% an Antibiotic Committee. Eleven per cent had formal antibiotic audit. Forty-eight per cent of respondents regulated pharmaceutical efforts to promote antibiotics within the hospital. The first survey of current practice suggests that attempts to control antibiotic use are widespread and generally believed to be useful. Several rarely used but potentially helpful control measures, such as specific forms for antibiotic prescriptions, were identified.