[Antibiotic use and misuse at the National University Hospital, Iceland]

Abstract

Introduction: Antibiotics are responsible for 20-25% of the total drug-cost in the larger hospitals in Iceland. Studies from other countries, both in Europe and North-America suggest that 40-70% of both antibiotic therapy and prophylaxis is inappropriate in the larger teaching hospitals. We undertook a prospective study to determine the patterns of antimicrobial use in a university hospital.

Methods: Data on antibiotic prescriptions were collected over two four week periods in April and August 1994 on 12 wards at the National University Hospital.

Results: During the eight weeks 302 (30%) of 1020 hospitalized medical, surgical and gynecological patients received one or more courses of antimicrobial therapy. Presumptive infection was the reason for therapy in 73% of the cases, prophylaxis in 35% and both therapy and prophylaxis in 8%. Cephalosporins were the most commonly used drugs for antimicrobial therapy and cloxacillin for prophylaxis. Therapy was judged appropriate in only 45% of the courses. Poor drug choice (bacterologically, pharmacologically), misguided prophylaxis, wrong drug dosage or unneccessary therapy were the most frequent reason for inappropriate therapy.

Conclusion: Because of the worldwide increase of antibiotic-resistant strains the results of this study clearly indicate the need for additional measures to improve antibiotic use.