Use and misuse of antimicrobial agents in a general hospital in the AIDS era

Abstract

A prevalence study was carried out to ascertain the pattern of antimicrobial use, costs and relevance in a general hospital during the AIDS era. All patients receiving antimicrobials were studied. Antimicrobials were divided into antibacterial drugs and others and the costs evaluated in US dollars. Of 1526 patients surveyed, 455 (29.8%) were receiving 664 courses of antimicrobials: 109 (7.2%) as prophylaxis and 346 (22.6%) as treatment. Fifteen percent of courses involved non-antibacterial drugs. In 188 patients (40.9% of those treated) treatment was inadequate, usually because of incorrect drug choice. Daily cost of antimicrobials was $14 953. AIDS accounted for 3% of all patients, 9% of those receiving antimicrobials, 19.7% of antimicrobial usage and 9.6% of the antimicrobial expenditure. Misuse occurred in 43% of non-HIV patients and 17% of those with HIV. Thus, despite a disproportionate contribution of patients with AIDS, adequacy of use of antimicrobials was better in this population.