POLK RE, JOHNSON CK, NICHOLS M; Interscience Conference on Antimicrobial Agents and Chemotherapy (42nd : 2002 : San Diego, Calif.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2002 Sep 27-30; 42: abstract no. O-1003.
Virginia Commonwealth Univ./Med. Coll. of Virginia Campus, Richmond, VA.
Hospitals are often characterized as having an "open" antimicrobial formulary when all antimicrobial drugs are available, or "closed" when availability is restricted. "Open" formularies may be less likely to promote resistance because of heterogeneous exposure. However the validity of these terms has not been critically assessed. A standard questionnaire was used to characterize hospital antibiotic formularies at 34 hospitals that participate in the SCOPE-MMIT Network. We determined actual antimicrobial use in DDD/1000 PD (defined daily dose/1000patient days) for all antibacterial drugs dispensed to inpatients in each hospital during 2000, and determined the proportion of the total for each major class (Table). All hospitals reported restrictions on antimicrobial availability (i.e. all had "closed" formularies), but there was marked variability in the kinds of restrictions. All but three hospitals used antibiotics (>1% of total use) from all four classes (FQ, Pb L, b LI or AG; Table) where restrictions are most often applied (i.e. in reality most hospitals had "open" formularies). * sum of 3[rd]/4[th] generation cephalosporins, carbapenems, monobactams. We defined a closed formulary as one where >/= 25% of total antibiotic use was from at least one of the following classes: DQ, Pb L, b -LI or Ag. By this definition, 14 hospitals had an open formulary and 20 hospitals had a closed formulary. In hospitals with closed formularies, FQs were most often used (15), followed by Pb L (8). The old definitions of "open" and "closed" formularies are not useful, and descriptions of antibiotic heterogeneity should be based on actual use and not administrative characterization.
Publication Types:
Keywords:
- Anti-Bacterial Agents
- Anti-Infective Agents
- Carbapenems
- Cephalosporins
- Formularies
- Formularies, Hospital
- Health Services Needs and Demand
- Hospitals
- Monobactams
Other ID:
UI: 102268085
From Meeting Abstracts