2007 Volume 22 Issue 4 Pages 253-259
This study was designed to compare antimicrobial use and cost, and outcome for pediatric patients with infection before and after implementation of the antimicrobial use notification policy or initiation of intervention by the infection control team (ICT) in our hospital. The policy was applied in October 2004, requiring the use of “special drugs” defined as anti-MRSA agents, fourthgeneration cephalosporins, carbapenems and broad-spectrum penicillin was notified to the infection control committee. Total antimicrobial use decreased by 15% (p<0.05) after policy implementation. The use of “special drugs” tended to decrease. In particular, use of fourth-generation cephalosporins significantly decreased by 85% (p<0.05), and use of anti-MRSA agents significantly decreased by 20% (p<0.01). Total antimicrobial expenditures decreased by 20%. In August 2005, we started ICT intervention for use of “special drugs”. To evaluate the effects of implementation of both the notification policy and ICT intervention, a retrospective assessment of a tenmonth time period of only policy implementation and a ten-month time period of both policy and ICT intervention implementation was performed. No significant change occurred in the use of anti-MRSA agents, carbapenems and second-generation cephalosporins during the policy only period, but the use of these agents decreased significantly (p<0.05) when the intervention by ICT was started. Comparing 2004 (a transition year) and 2006 (after full implementation of both programs), infection-related hospital mortality in pediatric patients in the intensive care unit decreased notably from 20% to 0%. Implementation of both antimicrobial use notification policy and ICT intervention resulted in substantial reductions in antimicrobial use and cost, and infectionrelated hospital mortality in the maternity center and children's hospital.
