Model for a formal, prospective antibiotic use review program.

A model for conducting prospective review of antibiotic orders is proposed. Before the drug is dispensed, a screening procedure is set up in which the incoming antibiotic drug order and the patient's drug profile are reviewed against previously established criteria. Noncompliance with any of the criteria is followed up as soon as possible with the prescriber who must either justify the noncompliance or authorize the changes necessary to achieve compliance. The drug is then dispensed. A prospective antibiotic review program combined with selective retrospective audits would be effective in assuring rational antibiotic use.