0
November 14, 1977, Vol 238, No. 20 >
ARTICLE | November 14, 1977

Review and Control of Antimicrobial Usage in Hospitalized Patients: Title and subTitle BreakA Recommended Collaborative Approach FREE

George W. Counts, MD
[+] Author Affiliations

Read in part before the annual meeting of the Association for Practitioners in Infectious Control, Hollywood, Fla, April 5, 1977.

Reprint requests to Division of Infectious Diseases, Harborview Medical Center, 325 Ninth Ave, Seattle, WA 98104 (Dr Counts).


JAMA. 1977;238(20):2170-2172. doi:10.1001/jama.1977.03280210062025
Text Size: A A A
Published online
Article
References

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 Bennett1 from 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.2-4 In 1974, Simmons and Stolley5 presented a strongly worded commentary on physician misuse of antibiotics. They suggested that "hundreds

REFERENCES

1 +
Scheckler WE, Bennett JV:  Antibiotic usage in seven community hospitals . JAMA 213:264-267, 1970;.
2 +
Roberts AW, Visconti JA:  The rational and irrational use of systemic antimicrobial drugs . Am J Hosp Pharm 29:828-834, 1972;.
3 +
Kunin CM, Tupasi T, Craig WA:  Use of antibiotics: A brief exposition of the problem and some tentative solutions . Ann Intern Med 79:555-560, 1973;.
4 +
Castle M, Wilfert CM, Cate TR, et al:  Antibiotic use at Duke University Medical Center . JAMA 237:2819-2822, 1977;.
5 +
Simmons HE, Stolley PD:  This is medical progress? Trends and consequences of antibiotic use in the United States . JAMA 227:1023-1028, 1974;.
6 +
Moser RH:  Another side of the coin . JAMA 227:1048-1049, 1974;.
7 +
Hendeles L:  Need for "counter-detailing" antibiotics . Am J Hosp Pharm 33:918-924, 1976;.
8 +
Dowling HF: Medicines for Man . New York, Alfred A Knopf Inc, 1970;.
9 +
Caldwell JR, Cluff LE:  Adverse reactions to antimicrobial agents . JAMA 230:77-80, 1974;.
10 +
Sherris JC:  The epidemiology of drug resistance , in Brachman PS, Eickhoff TC (eds): Proceedings of the International Conference on Nosocomial Infections . Baltimore, Waverly Press Inc, 1971;, pp 50-60.
11 +
Bulger RJ, Roberts CE, Sherris JC: Changing incidence of antibiotic resistance among Staphylococcus aureus, Escherichia coli, Aerobacter-Klebsiella, and Pseudomonas encountered in a teaching hospital over a seven-year period. Antimicrob Agents Chemother 1966, pp 42-46.
12 +
Ridley M, Barrie D, Lynn R, et al:  Antibiotic-resistant Staphylococcus aureus and hospital antibiotic policies . Lancet 1:230-233, 1970;.
13 +
Price DJE, Sleigh JD:  Control of infection due to Klebsiella aerogenes in a neurosurgical unit by withdrawal of all antibiotics . Lancet 2:1213-1215, 1970;.
14 +
Sogaard H, Zimmerman-Nielsen C, Siboni K:  Antibiotic-resistant gram-negative bacilli in a urological ward for male patients during a nine-year period: Relationship to antibiotic consumption . J Infect Dis 130:646-650, 1974;.
15 +
Zeman BT, Pike M, Samet C:  The antibiotic utilization committee . Hospitals 48:73-76, 1974;.
16 +
McGowan JE, Finland M:  Usage of antibiotics in a general hospital: Effect of requiring justification . J Infect Dis 130:165-168, 1974;.
17 +
 Guidelines for peer review, Veterans Administration Ad Hoc Interdisciplinary Advisory Committee on Antimicrobial Drug Usage . JAMA 237:1001-1002, 1977;.
18 +
Chodak GW, Plaut ME:  Use of systemic antibiotics for prophylaxis in surgery . Arch Surg 112:326-334, 1977;.
19 +
Jones SR, Bratton T, McRee E, et al:  The effect of an educational program upon hospital antibiotic use . Am J Med Sci 273:79-85, 1977;.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Scheckler WE, Bennett JV:  Antibiotic usage in seven community hospitals . JAMA 213:264-267, 1970;.
2 +
Roberts AW, Visconti JA:  The rational and irrational use of systemic antimicrobial drugs . Am J Hosp Pharm 29:828-834, 1972;.
3 +
Kunin CM, Tupasi T, Craig WA:  Use of antibiotics: A brief exposition of the problem and some tentative solutions . Ann Intern Med 79:555-560, 1973;.
4 +
Castle M, Wilfert CM, Cate TR, et al:  Antibiotic use at Duke University Medical Center . JAMA 237:2819-2822, 1977;.
5 +
Simmons HE, Stolley PD:  This is medical progress? Trends and consequences of antibiotic use in the United States . JAMA 227:1023-1028, 1974;.
6 +
Moser RH:  Another side of the coin . JAMA 227:1048-1049, 1974;.
7 +
Hendeles L:  Need for "counter-detailing" antibiotics . Am J Hosp Pharm 33:918-924, 1976;.
8 +
Dowling HF: Medicines for Man . New York, Alfred A Knopf Inc, 1970;.
9 +
Caldwell JR, Cluff LE:  Adverse reactions to antimicrobial agents . JAMA 230:77-80, 1974;.
10 +
Sherris JC:  The epidemiology of drug resistance , in Brachman PS, Eickhoff TC (eds): Proceedings of the International Conference on Nosocomial Infections . Baltimore, Waverly Press Inc, 1971;, pp 50-60.
11 +
Bulger RJ, Roberts CE, Sherris JC: Changing incidence of antibiotic resistance among Staphylococcus aureus, Escherichia coli, Aerobacter-Klebsiella, and Pseudomonas encountered in a teaching hospital over a seven-year period. Antimicrob Agents Chemother 1966, pp 42-46.
12 +
Ridley M, Barrie D, Lynn R, et al:  Antibiotic-resistant Staphylococcus aureus and hospital antibiotic policies . Lancet 1:230-233, 1970;.
13 +
Price DJE, Sleigh JD:  Control of infection due to Klebsiella aerogenes in a neurosurgical unit by withdrawal of all antibiotics . Lancet 2:1213-1215, 1970;.
14 +
Sogaard H, Zimmerman-Nielsen C, Siboni K:  Antibiotic-resistant gram-negative bacilli in a urological ward for male patients during a nine-year period: Relationship to antibiotic consumption . J Infect Dis 130:646-650, 1974;.
15 +
Zeman BT, Pike M, Samet C:  The antibiotic utilization committee . Hospitals 48:73-76, 1974;.
16 +
McGowan JE, Finland M:  Usage of antibiotics in a general hospital: Effect of requiring justification . J Infect Dis 130:165-168, 1974;.
17 +
 Guidelines for peer review, Veterans Administration Ad Hoc Interdisciplinary Advisory Committee on Antimicrobial Drug Usage . JAMA 237:1001-1002, 1977;.
18 +
Chodak GW, Plaut ME:  Use of systemic antibiotics for prophylaxis in surgery . Arch Surg 112:326-334, 1977;.
19 +
Jones SR, Bratton T, McRee E, et al:  The effect of an educational program upon hospital antibiotic use . Am J Med Sci 273:79-85, 1977;.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems