Review and Control of Antimicrobial Usage in Hospitalized Patients

THE 1976 Hospital Accreditation Standards on Infection Control established by the Joint Commission on the Accreditation of Hospitals (JCAH) now requires involvement of physicians in a review of antimicrobial usage in hospitalized patients. As stated, the hospital's infection control program is to "include the regular review of the clinical usage of antibiotics." In recent years, attention has been focused on antibiotic prescribing and the magnitude of the problem of inappropriate usage of antibiotics by physicians. Several factors have contributed to the call for scrutiny of physician antibiotic-prescribing patterns. In 1970, Scheckler and Bennett¹from the Center for Disease Control reported that 62% of patients receiving antibiotics in seven community hospitals had no evidence of infection. Similar findings concerning possible inappropriate use of antibiotics have been reported by others.²⁻⁴In 1974, Simmons and Stolley⁵presented a strongly worded commentary on physician misuse of antibiotics. They suggested that "hundreds