A Clinical Syndrome-Based Antibiotic Drug Use Evaluation: Impact on Antibiotic Use in a Large Teaching Hospital

Abstract

The traditional drug use evaluation (DUE) process fails to integrate well with the way patients are treated by physicians. In order to address the shortcomings of the traditional DUE process, a clinical syndrome-based antibiotic drug use evaluation was developed. The steps involved in the development and implementation of this process are described, with an emphasis on physician involvement in each step of the development process. Feedback loops to Medical Staff Quality Management Committees are an integral part of this program. Results of this program have been encouraging, with final physician compliance with the established guidelines occurring for 91% to 96% of the antibiotic orders written. This program has also resulted in a 10% decline in per day antibiotic expenditures, and has been instrumental in enabling the institution to tightly restrict antibiotic usage in response to outbreaks of multidrug-resistant organisms.