[Imipenem-cilastatin use in a university hospital in Chile].

Imipenem is an expensive broad-spectrum antimicrobial, reserved for infections caused by multi-resistant nosocomial pathogens. Since 2001 our university hospital applies a restriction policy that allows rejecting or authorizing its use after a supervising evaluation with pre-specified criteria for appropriate or inappropriate use. An audit was performed for all the supervisions made during the periods of March-April and September-October, 2004, totalling 136 treatments. In global terms, 58.1% of treatments were considered appropriate and 11.8% inappropriate; other 20.6% had been discontinued by physicians in charge prior to evaluation. Susceptibility to other antimicrobials compounds was the main reason for inappropriate use. The remaining fraction involved deceased or discharged patients. Discontinuation of treatments by supervising physicians allowed to save 75 days and 362 vials of imipenem equivalent to US $ 6,777 during this period after discounting administrative and human resources costs.