[Evaluation and utilization patterns of antibiotic therapy. A study in 4 hospital departments].
The use of antibiotics in 480 cases in 4 hospital wards during 1988 was assessed by examination of medical records. Only the first antibiotic therapy administered during the first stay in the ward for each patient was included. Antibiotics were administered to 163 in-patients (37% of hospitalizations) for infections in 113 (26%) cases. Amoxycillin and macrolides were the drugs most frequently used. Sixty-eight percent of the treatments were administered in the absence of microbiological data. Single drug therapy was used in 60% of treatments. Fifty in-patients (11% overall; 41% of patients undergoing surgery) received antibiotics for prophylaxis. The exact indication(s) for the choice of therapy was not given in the medical records of 39% of cases. Treatment started within 48 hours of infection in 15% of the cases. Overall, 93% of the treatments given were indicated, but 53% were inappropriate because they were too expensive, unlikely to be effective or were multiple drug therapy without justification. There are a variety of factors that cause such inappropriate administration of antibiotics.