Guidelines for Antimicrobial Usage
About the Guidelines for Antimicrobial Usage 2012-2013
The majority of hospitalized patients receive antimicrobials for therapy or prophylaxis during their inpatient stay. It has been estimated that at least ſfty percent of patients receive antimicrobials needlessly. Reasons include inappropriate prescribing for antimicrobial prophylaxis, continuation of empiric therapy despite negative cultures in a stable patient, and a lack of awareness of susceptibility patterns of common pathogens. Over prescribing not only increases the costs of health care, but may result in superinfection due to antimicrobial-resistant bacteria, as well as opportunistic fungi, and may increase the likelihood of an adverse drug reaction. On the other hand, not prescribing (when there is an urgent need at the bedside) may also lead to serious consequences.
The materials in this booklet constitute guidelines only and are subject to change pursuant to medical judgement relative to individual patient needs. Our antimicrobial formulary decisions are made annually after thorough deliberations and consensus building with members of the Infectious Disease Department, the Department of Pharmacy, and the Section of Microbiology. In vitro susceptibility data of the previous year are shared and emerging resistance patterns reviewed. Usage and cost data are discussed. The mission of our program is to provide the most cost-effective antimicrobial agents to our patients.
This booklet does not contain speciſc guidelines for treatment of human immunodeficiency virus (HIV) infection. Nor is prophylaxis against opportunistic microorganisms included, since such issues are usually handled in our outpatient clinics. Similarly, treatment of infectious diseases commonly seen in the outpatient setting, such as otitis media and pharyngitis, are not included in this booklet.