Antibiotic control in a municipal hospital

The choice of an antibiotic for a patient is often a difficult decision. The clinician must contend with a bewildering variety of bacteria and use a number of expensive and toxic antimicrobial agents judiciously. To deal with the problems of excessive and inappropriate use, the medical staff of Coney Island Hospital established compulsory, prospective antibiotic control. Two years after initiation of this program, we analyzed changes in sensitivity patterns of hospital flora, physicians' prescribing habits, and antibiotic use. A trend toward increasing resistance on the part of some Gram-negative isolates to certain β-lactam antibiotics was noted. Antibiotic costs decreased an average of 38%, while prescribing skills improved. (JAMA241:2283-2286, 1979)