Optimizing antibiotic use in hospitals: the role of population-based antibiotic surveillance in limiting antibiotic resistance. Insights from the society of infectious diseases pharmacists

Pharmacotherapy. 2003 Dec;23(12):1627-33. doi: 10.1592/phco.23.15.1627.31967.


To minimize antibiotic resistance, pharmacists increasingly are becoming involved in antibiotic surveillance, formulation of antibiotic use policies, and day-to-day control of problematic antibiotic use. Population-based antibiotic surveillance has become common with the proliferation of electronic databases. The most widely applied measure of antibiotic consumption is the defined daily dose/1000 patient days. Most studies correlating antibiotic consumption with resistance have focused on antibiogram-related end points; antibiogram data generally reflect institutional nosocomial infection patterns. Most study designs have been derived from traditional epidemiology such as case-control with regression modeling or simple linear regression; however, these methods have limitations. Several experimental designs show promise. Many historical-control studies, including a multicentered study, suggest that population-based antibiotic surveillance and policy intervention can decrease antibiotic resistance in hospitals. Further research on the relationships among antibiotic surveillance, structured antibiotic policy interventions, and other microbiologic, patient-oriented, and economic end points is needed.

Publication types

  • Review

MeSH terms

  • Anti-Infective Agents / administration & dosage
  • Anti-Infective Agents / therapeutic use*
  • Drug Resistance*
  • Drug Utilization Review / methods*
  • Guideline Adherence / standards
  • Hospitals / standards*
  • Humans
  • Pharmacy Service, Hospital / methods
  • Pharmacy Service, Hospital / standards
  • Product Surveillance, Postmarketing / methods*


  • Anti-Infective Agents