Parret T, Schneider R, Rime B, Saghafi L, Pannatier A, Francioli P
Division autonome de Médecine préventive hospitalière, CHUV, Lausanne.
Schweiz Med Wochenschr. 1993 Mar 13;123(10):403-13.
The inappropriate use of antibiotics has been documented by several studies. Most of these studies have been performed in the USA and there is very little data from Europe and Switzerland. A three-month prospective study was carried out at the University Medical Center of Lausanne in the departments of internal medicine, general surgery and traumatology. During this period, 2112 patients were hospitalized among whom 878 received one or more courses of antibiotic therapy: the treatment was given prophylactically in 35% of the cases and therapeutically in the other 65%. A total of 1165 antibiotic prescriptions were evaluated. The administration of the antibiotic was considered to be indicated in 96% of the cases. However, 24% of the prescriptions contained at least one error. 50% of the errors were observed in prophylactic treatments and most were related to the length of administration and the spectrum of the agents. The errors in therapeutic prescription were found mainly in indications for urinary and respiratory tract infections, and were related to the spectrum of the antibiotic and the length of treatment. It was calculated that the inappropriate use of antibiotics accounted for approximately 7% of the total costs of all antibiotics used. We estimated that half of this excess in costs could probably be saved by the introduction of simple corrective measures mainly directed at limiting the duration of administration.
多项研究记录了抗生素的不当使用情况。这些研究大多在美国进行，来自欧洲和瑞士的数据非常少。在洛桑大学医学中心的内科、普通外科和创伤科进行了一项为期三个月的前瞻性研究。在此期间，2112名患者住院，其中878人接受了一个或多个疗程的抗生素治疗：35%的病例为预防性治疗，其余65%为治疗性治疗。共评估了1165份抗生素处方。96%的病例中抗生素的使用被认为是合理的。然而，24%的处方至少包含一个错误。50%的错误出现在预防性治疗中，大多数与给药时长和药物谱有关。治疗性处方中的错误主要出现在泌尿系统和呼吸道感染的用药指征方面，与抗生素的药物谱和治疗时长有关。据计算，抗生素的不当使用约占所有使用抗生素总成本的7%。我们估计，通过引入主要针对限制给药时长的简单纠正措施，可能可以节省这一额外成本的一半。
