A multi-cross-sectional study was conducted in a 2000-bed tertiary care university hospital in Bangkok, Thailand, from September 1993 to May 1994 to assess the effectiveness of an educational program on the use of
antibiotics. Data on the study covered
antibiotic usage both in-patients and out-patients. Data were collected for a 24-hour period every 2 weeks for 7 days for each 3-month period. The target population were residents, general practitioners, and sixth-year medical students. The educational program provided information derived from the data of inappropriate use of
antibiotics during the pre-intervention period and guidelines on the use of
antibiotics which were agreed to by a consensus among the faculty in all clinical departments. The study revealed: (1) the prevalence of
antibiotic use and the cost of
antibiotics during post-intervention period was significantly decreased by 20%; (2) the use of
antibiotic prophylaxis for obstetrics patients and patients undergoing
cataract surgery decreased significantly; (3) there was a shift from second or
third generation cephalosporins to
cefazolin for surgical prophylaxis; (4) the duration of perioperative
antibiotic prophylaxis was reduced to under 2 days; (5) there was a shift from
netilmicin or
amikacin to
gentamicin for the treatment of
community acquired infection; and (6) the mortality, median length of
hospital stay, and
nosocomial infection rate among the patients who received
antibiotics during the post-intervention period were not significantly different from those during the pre-intervention period. These results suggest that this educational program comprising information feedback and
antibiotic usage guidelines was effective in improving
antibiotic use at this tertiary care university hospital in Thailand.