Optimal antibiotic use contributes to cutting healthcare costs

Globally, rising antibiotic resistance is mainly due to the increasing use of antibiotics [1]. There are several reasons for this increased use, such as ageing of the patient population, increased use of medical devices and increased possibilities for extensive surgery. However,  it is also known that 50% of all medical antibiotic use is incorrect, that is in terms of indication, choice, way of administration and /or duration [2]. In this article, the focus is on the empiric choice and steps to be taken to make an optimal choice.

Dr C. van der Donk, Dr C. den Heijer and Dr E. Stobberingh

An example of wrong indication is the use of antibiotics in case of a respiratory tract infection which is caused by a viral agent. An incorrect way of administration is the topical use of an antibiotic in case of a severe wound infection. An example of an incorrect − too short − duration is a one-day therapy with amoxicillin for the treatment of an uncomplicated urinary tract infection; likewise, a 14-day therapy for the same indication indicates a too long duration. An incorrect choice would focus mainly on the empiric choice of an antimicrobial agent. An empiric antibiotic choice means to make a choice without knowing the causative agent of the infection to be treated and/or the antibiotic susceptibility pattern of this putative agent.

Before making an optimal empiric choice
Most infections are caused by the patient