Send Orders for reprints to reprints@benthamscience.net Current Drug Safety, 2014, 9, 1-34 1 1574-8863/14 $58.00+.00 © 2014 Bentham Science Publishers Appropriate Utilization of Restricted Antibiotics in a General Hospital of a Perfecture Area in Greece Saridi Maria *,1 , Rekleiti Maria 1 , Toska Aikaterini 1 , Kriebardis G. Anastasios 2 , Tsironi Maria 3 , Syrigos Konstantinos and Souliotis Kyriakos 5 1 General Hospital of Korinthos, 53 Athinon Av., GR20100, Korinthos, Greece 2 Technological Institute Education (T.E.I.) of Athens, Faculty of Health and Caring Professors, Department of Medical Laboratories, Laboratory of Haematology and Transfusion Medicine, Ag. Spiridonos & Dimitsanas, 12210, Aigaleo, Athens, Greece 3 University of Peloponneses, Dept of Nursing, University of Peloponnese, Orthias Artemidos & Plataion GR23100, Sparti, Greece. 4 Oncology Unit, 3rd Dept. of Medicine, Athens University School of Medicine Building Z, Sotiria General Hospital, Mesogion 152, GR-115 27 Athens, Greece 5 Faculty of Social Sciences, Department of Social and Educational Policy, University of Peloponnese, Korinthos, Greece, Damaskinou & Kolokotroni St., GR20100 Korinthos, Greece Abstract: Introduction: Over-consumption of antibiotics has led to increased bacterial resistance and higher prevalence of hospital -acquired infections, resulting in rising treatment costs and prolonged length of hospital stay. The purpose of the study was to correlate the use of restricted antibiotics with recommended diagnosis and cost. Material and Methods: All restricted antibiotics that were administered in a 240-bed general hospital in a semi-urban area within a year were recorded. The reason for administering each such antibiotic during the first three months of the study was also recorded. PASW 18 (SPSS Inc.) was used for the statistical analysis; a variable was considered statistically significant when statistical significance was p= 0.05. Results: 1118 patients were registered, of which 35,05% were employees, insured with IKA, 33,05% were farmers and covered by OGA and 31,9% were insured in other Social Insurance Funds or uninsured. The most commonly administered antibiotic combination was that of piperacillin/tazobactam, which was mainly used in the Internal Medicine Dept. of the Hospital. The most commonly used restricted antibiotic, administered after an antibiogram, was the combination of piperacillin/tazobactam (n= 13), mainly prescribed for respiratory infection. One third of the recorded restricted antibiotics were administered before an antibiogram had been taken for fever of unknown origin (n= 128). Conclusions: Rational use of restricted antibiotics is an important component of public health policies aiming at reducing hospital-acquired infections. Hospitalization costs rise when restricted antibiotics are used, and the possibility for the development of resistant bacteria increases. Keywords: Antibiotic consumption, antibiotics, antimicrobial resistance, chemoprophylaxis, cost, under restriction antibiotics. INTRODUCTION Irrational over-consumption of antibiotics has led to the development of antibiotic-resistant bacteria that can replace the normal microbial fauna [1, 2]. Microbial resistance is an important public health issue, since it can restrict the menu of antibiotics available to the physician, it can increase patient length of stay, and can accordingly increase treatment costs and mortality rates [3]. The plethora of antibiotic drugs since the 1980s has also led to the irrational use and misuse of those valuable drugs [4, 5]. *Address correspondence to this author at the General Hospital of Korinthos, 53 Athinon Av., GR20100, Korinthos, Greece; Tel: +302741361563; E-mail: sarmar32@windowslive.com Since 2003, Greece is continuously first among the other European countries in antibiotic consumption in community and hospital level. According to the European Surveillance of Antimicrobial Consumption (ESAC), Greece is first in Europe especially in community antibiotic use with a graduated increase from 25.06 DID in 1997 to 34.73 DID in 2005 (DID: Daily Defined Dose per 1000 Inhabitants per Day) [6]. Antimicrobials are very often prescribed for viral conditions or diseases for which antibiotics are not indicated, or are administered in incorrect dosages deviated from the international prescribing guidelines. It is also common the incorrect choice of an antibiotic used empirically, which is not in agreement with the results of cultures and antibio- gramme.