A Program for Optimizing the Use of Antibiotics in the Hospital Setting: Experience in a Spanish Regional Hospital

Abstract

We here describe the implementation of a program for optimizing the use of antibiotics (PROA) in a 128-bed regional hospital in Barakaldo, Spain, and the results obtained at 6 months. The study was a quasi-experimental prospective intervention study using a historical control group. A non-restrictive intervention model to help prescription, with a direct and bidirectional intervention was developed. The program consisted of an optimization audit of the use of antibiotics without pre-established personalized guidelines. Variables assessed included antibiotic consumption and costs, cost per process, mean hospital stay, and percentage of hospital readmissions. Data obtained during the 6-month study period (November 2013-April 2014) were compared with data collected between November 2012 and April 2013. A total of 307 audits were performed. In 65.8% of cases, treatment was discontinued between the 7th and the 10th day. The main reasons of treatment discontinuation were completeness of treatment (43.6%) and lack of indication (14.7%). The reduction of pharmaceutical expenditure was 8.59% (P=0.049) and 5.61% of the consumption in defined daily dose (DDD)/100 stays (P=0.180). The costs by processes in general surgery showed a 3.14% decrease (P=0.001). These results confirm the efficiency of implementing programs for optimizing the use of antibiotics in medium-sized hospitals with limited resources.