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Optimizing Antibiotic Use in Hospitals: The Role of Population‐Based Antibiotic Surveillance in Limiting Antibiotic Resistance Insights from the Society of Infectious Diseases Pharmacists
Author(s) -
MadarasKelly Karl
Publication year - 2003
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.23.15.1627.31967
Subject(s) - antibiotics , antibiotic resistance , medicine , intensive care medicine , population , infection control , defined daily dose , environmental health , biology , microbiology and biotechnology
To minimize antibiotic resistance, pharmacists increasingly are becoming involved in antibiotic surveillance, formulation of antibiotic use policies, and day‐to‐day control of problematic antibiotic use. Population‐based antibiotic surveillance has become common with the proliferation of electronic databases. The most widely applied measure of antibiotic consumption is the defined daily dose/1000 patient days. Most studies correlating antibiotic consumption with resistance have focused on antibiogram‐related end points; antibiogram data generally reflect institutional nosocomial infection patterns. Most study designs have been derived from traditional epidemiology such as case‐control with regression modeling or simple linear regression; however, these methods have limitations. Several experimental designs show promise. Many historical‐control studies, including a multicentered study, suggest that population‐based antibiotic surveillance and policy intervention can decrease antibiotic resistance in hospitals. Further research on the relationships among antibiotic surveillance, structured antibiotic policy interventions, and other microbiologic, patient‐oriented, and economic end points is needed.