A practical method of antimicrobial surveillance.

This antimicrobial surveillance program clearly relates inpatient antimicrobial usage to therapeutic or prophylactic indications. One nurse-epidemiologist gathers data for a medium-sized Veterans Administration hospital, in addition to carrying out infection surveillance and educational responsibilities, and reviews the data weekly with an infectious disease physician. Usage of antimicrobials for surgical prophylaxis is the area where violations of generally accepted criteria for usage can be most readily documented. Only 31% of usages were deemed appropriate. A similar percentage (about 65%) of antimicrobial usages were judged "appropriate" on the medical and surgical services in treatment of wound and urinary tract infection. Treatment of respiratory tract infection and sepsis was judge "appropriate" in over 85% of instances on the medical service. These categories contained too few cases to summarize on the surgical service.