Stanford Antimicrobial Safety and Sustainability Program

On average, approximately 60% of hospitalized patients receive an antibiotic and in an estimated one-half of cases antibiotic use is inappropriate. The latter is the result of administration of an antibiotic when none is indicated, the use of the wrong antibiotic, incorrect dosing, or an incorrect duration of administration. This can result in harm to the patient as a result of the receipt of inadequate treatment for his or her infection, direct toxic effects of the antibiotic, allergic reactions, and superinfection with resistant bacteria, as well as collateral damage such as the development of colitis due to the toxins of Clostridium difficile.

In addition, antibiotic use, both appropriate and inappropriate, has the potential for important societal harm as a result of the selective pressure it exerts upon the bacterial ecology with the resultant increased prevalence of antimicrobial resistance. In this regard, antibiotics are unlike any other class of medications because of the potential public health consequences of their selection of resistant bacteria, which may become dominant in the hospital and the community.