Management Programs Control Hospital Antibiotic Policy

Antibiotics are used in three general settings: hospitals, community, and agriculture. Only hospitals are starting to take responsibility for stewardship. (The Food and Drug Administration is responsible for efficacy and safety, not drug longevity.) Antibiotic management teams now guide prescribing policies of most U.S. hospitals (see Box 7-1). Among their activities is approving only certain antibiotics for hospital use. These antibiotic lists, called formularies, generally include only a few members of each antibiotic class. Formularies enable the entire hospital to take advantage of local infectious disease experts, and formularies help hospitals negotiate discount prices from pharmaceutical suppliers who want their product listed on the formulary.