Effects of a restrictive antibiotic policy on clinical efficacy of antibiotics and susceptibility patterns of organisms.

To assess the impact of a restrictive antimicrobial policy, the efficacy of therapeutic and prophylactic antibiotic regimens and the susceptibility patterns of infecting bacterial microorganisms were studied during a two-month period in 1986 in inpatients in a general hospital. Twenty-eight percent of patients received antimicrobial agents, 21% as treatment and 7% as prophylaxis. In the 359 evaluable episodes of infection cure was obtained in 88% of cases with the initial therapy and in 7% after a change of drugs, but treatment failed in 5%. Of the 18 cases of failure, improvement was seen in eight although the infection persisted. Ten patients died but in seven of them the infection only partially contributed to this outcome. Ten (8%) of 127 patients receiving antimicrobial prophylaxis developed an infection but in three there was no relation to the condition for which the prophylactic regimen was originally prescribed. No changes were found in the susceptibility patterns of microorganisms.