The Effect of Aminoglycoside Restriction on the Resistance Pattern and Mortality of Nosocomial Bacteremia Caused by Gram-Negative Bacilli
Infection and Chemotherapy
;
: 192-198, 2003.
Article
in Korean
| WPRIM
| ID: wpr-722332
ABSTRACT
OBJECTIVE:
To evaluate the effects of an aminoglycoside restriction policy on expenditures for aminoglycosides, antimicrobial resistance rates and clinical outcome of nosocomial bacteremia caused by Gram-negative bacilli (GNB).METHODS:
Starting in February, 2002, a prior consultation with an infectious disease specialist for using aminoglycoside antibiotics over 5 days was required in a 930-bed university hospital. In retrospective analysis of medical records 7 months after initiation of the aminoglycoside restriction policy, sixty cases of clinically relevant nosocomial bacteremia caused by GNB were found. These bacteremic patients were compared with sixty, species-matched, control patients with nosocomial Gram- negative bacteremia before the policy for total expenditures for aminoglycosides, susceptibility to antibiotics and clinical outcomes of bacteremia.RESULTS:
During the same period of 7 months before and after the restriction policy, total expenditures for aminoglycosides decreased by 44% in cost (from 465,030,841 Won to 259,618,337 Won) and the antimicrobial utilization density of aminoglycosides decreased by 42% (from 225.2 to 130.3). On the other hand, the patterns of antibiotic susceptibility and bacteremia-related in-hospital mortality rates after the policy did not show a significant change, compared with those before the policy.CONCLUSION:
Antibiotic restrictions are among the most popular methods to diminish the practice of antibiotic overuse in hospitals. In this study, requirement for prior approval of aminoglycoside use over 5 days led to a significant decrease in the amount and cost of total aminoglycosides without a significant change in susceptibility patterns and bacteremia-related mortality rates.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Specialization
/
Medical Records
/
Communicable Diseases
/
Retrospective Studies
/
Mortality
/
Hospital Mortality
/
Bacteremia
/
Health Expenditures
/
Aminoglycosides
/
Hand
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
Infection and Chemotherapy
Year:
2003
Type:
Article
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