Optimization of antibacterial therapy to minimize costs, medication errors, and adverse outcomes

As noted in the widely publicized Institute of Medicine report, medical errors are a major cause of mortality, morbidity, and excess health care costs (1). A substantial portion of these medical errors are medication errors that lead to preventable adverse drug events (ADEs). In the United States, the estimated cost of a preventable ADE ranges from $2, 600 to $6, 800 (based on year 2000 values) in hospitalized patients and from $700 to $2, 200 in outpatients requiring emergency department evaluation or hospital admission. When extrapolated to a nationwide basis, the combined annual cost is in the range of $2 billion to $3 billion (2). Antibacterial agents represent the class of drugs most cited as the subject of ADEs (3, 4). Furthermore, the adverse effects attributable to antibacterial agents are not limited to minor reactions. This class has been found to be a major cause of fatal ADEs (5).