Infections and Antibiotic Use in a Community Hospital, 1971-1990

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Abstract
Objective: To determine the prevalence of infections and antibiotic use at a community' hospital in 1990 and to compare the results with those from previous surveys in 1971, 1979, and 1984. Design: Point prevalence survey. Setting: Community teaching hospital. Patients: All hospitalized patients, excluding those on the nursery, psychiatry, and short-stay wards. Intervention: Medical records were reviewed and a pertinent physical examination was performed on each patient. Results: Overall, 46 (20.1%) of 229 patients had infection in 1990. Community-acquired and hospital-acquired infections were present in 26 (11.4%) and 24 (10.5%) of the patients, respectively. The most common site of community-acquired infection was the deep abdomen in 8 (25.8%) of 32 sites, while hospital-acquired infection most frequently involved the lower respiratory tract in 8 (25.0%) of 32 sites. Antimicrobial agents were being administered to 88 (38.4%) of the patients. Cephalosporins (particularly newer, broad-spectrum agents) were the most frequently used antibiotics, comprising 53 (45.3%) of the 117 total antimicrobial prescriptions. Seven (18.4%) of the 38 antibiotics used for surgical prophylaxis were given for more than 48 hours. Trend analysis revealed no significant changes in the proportions of patients with community-acquired, hospital-acquired, or total infection over the last 20 years (p=.18, p=.12, and p=.07, respectively). While the overall use of antibiotics increased (p