Failure of a restriction list-based antibiotic policy to reduce the consumption of two antibiotics recently added to this list

Abstract number: P762

Loupa C., Tzannou I., Tsolaki V., Katsiki-Divari E., Anapliotis P., Karnezi K.I., Tsakoniatis M., Lelekis M.

Background and Objectives: According to an antibiotic restriction policy implemented in Hellenic hospitals since late 80 s, all potent antibiotics (3rd and 4th generation cephalosporins, aztreonam, carbapenems, quinolones and glycopeptides and more recently linezolid, daptomycin and tigecycline) are included in a restriction list and can be dispensed by the hospital pharmacy only if the treating doctor fills in a specific form. However, ticarcillin–clavulanate (t/c) and piperacillin–tazobactam (p/t) were added to this list long after their introduction to the market and after a very successful course in Hellenic hospitals (at least for the latter). Our purpose was to study the impact of this kind of restriction policy on the consumption of t/c and p/t in our 300-bed hospital.

Methods: We retrospectively studied t/c and p/t consumption in our hospital by month from January 2007 to August 2008. We used data from the pharmacy computer. Antibiotic use was calculated in DDDs per 1000 patient days (ABC Calc 3.0_b). The values before and after restriction implementation (mid-June 2007) were studied with linear regression analysis (SPSS 11.5) for possible trend.

Results: P/t consumption was 15.4, 28.1, 19.1, 19.5, 18.3, 26.8 DDDs per 1000 patient days for the months January 2007 to June 2007 and 18.1, 21.6, 15.6, 29.1, 34.9, 29.8, 16.8, 21.5, 14.1, 27.8, 25.0, 15.1, 18.1, 12.7 for the months July 2007 to August 2008, respectively, and no statistical trend was found. The values for t/c consumption were 3.1, 1.6, 3.3, 0.3, 3.5, 0.3 (January to June 2007) and 6.1, 2.4, 8.1, 0, 4.4, 4.1, 6.8, 9.1, 1.7, 1.0, 4.4, 8.6, 5.2, 3.9 for the 14 months after restriction and again no trend was found. Furthermore, the mean per month consumption for p/t was 20.1 and 21.6 DDDs per 1000 patient days before and after restriction implementation respectively, and that of t/c 2.4 and 4.7 DDDs per 1000 patient days respectively.

Conclusions: The addition of t/c and p/t to the antibiotic restriction list failed to reduce their consumption in our hospital during the study period. Besides it is worth noting that, almost two decades after the introduction of the above mentioned restriction policy in the Hellenic hospitals, no formal audit has ever been performed. Perhaps it is time for us to revise our antibiotic policy.

Session Details

Date: 16/05/2009
Time: 00:00-00:00
Session name: 19th European Congress of Clinical Microbiology and Infectious Diseases
Location: Helsinki, Finland, 16 - 19 May 2009
Presentation type:
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