ABSTRACT
Antimicrobials are among the most frequently used drugs worldwide, especially in developing countries, where there are limited data on the use of these therapeutic agents. The Pharmacy Service and the Hospital Infection Control Commission (HICC) of a medium complexity university hospital, concerned about the rational use of broad-spectrum antimicrobials, have devised a sequential intervention program to improve the use of the antibiotics ceftazidime, ciprofloxacin, imipenem and vancomycin in Intensive Care Units (ICUs). The program was developed in three successive steps lasting six months each: baseline data collection (November 2001 to April 2002), initial intervention period (May 2002 to October 2002), educational intervention program (November 2002 to April 2003). All the ICU antimicrobial prescriptions were reviewed and consumption was converted into Defi ned Daily Doses per 100 patient-days and tabulated to compare different periods and the respective costs. A total of 459 ICU patients were followed through. A change in the profile of antimicrobial prescriptions was observed: a reduction in the use of broad spectrum antimicrobials, reduced number of antimicrobials per patient and improvement in etiological investigation of infection. Significant reductions of ciprofl oxacin (69.2%), imipenem (56.3%) and vancomycin (39.0%) consumption were observed. Total cost savings, based on the data for the four drugs, was US$31,523.58 (58.6%). The multidisciplinary educational intervention program was thus responsible for both an improvement in the use of broad-spectrum antimicrobials in the ICU and cost savings.