To assess current antibiotic use and the impact on prescribing of hospital antibiotic policy, a prospective one-day prevalence survey of antibiotic use in both in-patients and out-patients was undertaken at St Thomas' Hospital. Of 921 in-patients, 196 (21%) received 269 antibiotic prescriptions on the survey day. Approximately 40% of in-patients received prophylaxis and 60% received treatment. Among 1521 out-patients, 292 (19%) were given a prescription on the survey day and 102 (7%) received an antibiotic prescription. Assessment of in-patient use with reference to the current hospital antibiotic policy was made mainly on microbiological grounds, on choice and dosage of agents. Choice of antibiotic was largely in accord with antibiotic policy, but was considered inappropriate in 12.5% of 81 in-patients given prophylaxis and 2.5% of 120 in-patients given treatment. Dosage of some major agents and timing of surgical prophylaxis was also considered inappropriate in many patients. A simple one-day survey is a useful indicator of antibiotic use in the hospital, and shows where further guidance to prescribers could be provided.
A multicentre study was carried out in general practice to investigate the efficacy, safety and tolerance of cephalexin in the treatment of infections in 194 patients with an underlying chronic disease or other complications, and in patients over the age of 65 years. For comparison, a group of 145 patients with no such complicating conditions was included in the study. Altogether, 339 patients were treated with doses of 1 g or 2 g cephalexin daily depending on the type and severity of infection. After treatment for 5 days, over 80% of patients were cured or much improved, with no differences between the two groups. Of the 95 patients who received 10-days' treatment, the clinical outcome was considered satisfactory in approximately 80% in both groups. No clinically significant biochemical changes were recorded, no drug interactions with concurrent therapy were reported, and the incidence of side-effects was low.
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