Concurrent antibiotic-use review in a small hospital.

A method of concurrent antibiotic-use review in a 60-bed pediatric hospital is described. The pharmacy department monitors appropriateness of antibiotic prescribing using criteria specified by the pharmacy and therapeutics committee. Antibiotic orders are reviewed by the pharmacist for compliance with the criteria at the time that the orders are written. At three-month intervals, information about the infections treated and the percentage compliance for all physicians, as well as for each individual physician, is compiled and reported to the pharmacy and therapeutics committee. Written and oral feedback are provided to each physician to further improve compliance. This comprehensive monitoring system has resulted in substantial improvement in antibiotic prescribing by physicians at this hospital.