Quality of antibiotic utilization for pneumonia in mental healthcare setting: Assessment through a computerized surveillance program in a university‐affiliated psychiatric hospital

Background There is virtually no information in the medical literature on the quality of antibiotic prescribing in mental healthcare setting. We report the results of an antibiotic utilization review focused on pneumonia in a university‐affiliated psychiatric hospital comprising 410 adult beds. Methods We implemented a computerized system for declaring any bacterial infection. This system was automatically triggered as soon as an antibiotic was prescribed through computerized physician drug‐order entry. Once the infection declaration was completed by the physician, infection data, patient data, and pharmacy data were automatically interfaced and gathered by the program into a final infection report. Infection reports were prospectively examined by the pharmacy department to evaluate the appropriateness of antibiotic orders relative to the current antibiotic guidelines for pneumonia in our hospital. Results Over a 19‐month period, 102 pneumonia (of which 81 were nosocomial) have been declared in 86 adult patients. The rate of compliance with guidelines was 49%. There were 77 reasons of inappropriateness recorded in 52 antibiotic orders. Problems were in the choice of antibiotic relative to the mode of acquisition of pneumonia (20), the daily dosage (25), and the duration of treatment (32). Conclusion The rate of inappropriate antibiotic prescribing for pneumonia in our psychiatric hospital was similar to that reported for antibiotic prescribing in general acute hospitals, i.e. around 50%. Clinical Pharmacology & Therapeutics (2005) 77 , P71–P71; doi: 10.1016/j.clpt.2004.12.163