Rational use of antibiotics in hospitals

Abstract

BACKGROUND: The Norwegian antibiotic policy emphasises use of narrow-spectrum antibiotics and has been regarded as successful. We have a low occurrence of antibiotic resistance, but hospital use of antibiotics in general, and broad-spectrum antibiotics specifically, has increased substantially the last 10 years. We now see a trend towards increasing antibiotic resistance, which will inevitably lead to the same serious resistance problems in Norway as abroad. MATERIAL AND METHODS: We have assessed resistance profiles for the most common human pathogens in Norway in the light of literature retrieved through a non-systematic search of PubMed and Norwegian literature on rational antibiotic use. The article emphasises pharmacodynamic and pharmacokinetic aspects, as well as ecological side effects of antibiotics and discusses rational treatment of the most common infections in Norwegian hospitals. RESULTS: Most research in this context is performed in settings with different antibiotic resistance patterns and attitudes towards antibiotic treatment than in Norway; few studies have focused on rational antibiotic use in Norwegian hospitals. We conclude that "old-fashioned" narrow-spectrum antibiotics can still be used in Norwegian hospitals, as there is little resistance to these agents. INTERPRETATION: It is still possible to treat most infections in Norwegian hospitals with narrow-spectrum antibiotics. We encourage physicians to adhere to the Norwegian antibiotic therapy tradition.