Monitoring antibiotic usage in the hospital

Strategies for controlling antibiotic use in a tertiary-care paediatric hospital

The need to control antibiotic use has grown out of concern for costs and emerging resistance. The paediatric population poses some different opportunities and barriers for controlling antibiotic use. Several strategies to promote rational antibiotic use that have been introduced at The Hospital for Sick Children, Toronto, Ontario are presented. These include a formulary system, restricted drug program, therapeutic interchange program, sequential antibiotic therapy, automatic stop orders, antibiotic order forms, drug use evaluation program, guidelines for antibiotic use, standardized dosing, educational efforts, appropriate use of culture and sensitivity reporting, rational use of therapeutic drug monitoring and monitoring by pharmacists of antibiotic use.