AUDIT OF ANTIBIOTIC USAGE IN A MEDIUM-SIZED GENERAL-HOSPITAL OVER AN 11-YEAR PERIOD - THE IMPACT OF ANTIBIOTIC POLICIES

The objective of the present study was to evaluate trends in antibiotic expenditure over an 11-year period (1982-1992) in a 370-bed district general hospital in Northern Ireland and to examine the impact of two separate antibiotic policies on antibiotic usage. A further objective was to examine the attitudes of prescribers to the second policy. Drug utilization review was used to collect information on antibiotic expenditure and usage before and after introduction of separate antibiotic policies in 1985 (not intensively monitored) and 1989 (intensively monitored). A mail questionnaire was used to determine the attitudes of prescribers. The first policy (1985) showed no benefits with regard to the number of antibiotic entities stocked (45 before, 45 after), number of dosage units issued (9.35 increase) or expenditure (33.35 increase). The 1989 policy led to significant reductions in the number of antibiotic entities stocked (28.9%), number of antibiotics issued (11.9%) and expenditure (6.1%). Expenditure began to spiral upwards when active monitoring of the second policy was suspended. The majority of prescribers (87.2%) who responded to the questionnaire (56.5% response rate) felt that the 1989 policy made a positive contribution to antibiotic usage in the hospital.

Comparative growth rates and internal banding periodicity of maerl species (Corallinales, Rhodophyta) from northern Europe

Maerl is a type of rhodolith, found in ecologically important beds of high conservation value; a major conservation objective is to establish growth rates. Maerl shows internal banding of controversial periodicity that may contain a high-resolution record of palaeoceanographic-palaeoclimatic data. To investigate growth rates and banding periodicity, we used the vital stain Alizarin Red in combination with scanning electron microscopy (SEM). Three maerl species, Phymatolithon calcareum, Lithothamnion corallioides and L. glaciale, were collected from maerl beds in Ireland. Following staining, maerl was grown in three controlled temperature treatments and at two depths in the field (P. calcareum only), with Corallina officinalis as a control for the stain. Alizarin Red was shown to be a suitable marker for growth in European maerl species and for C. officinalis. The average tip growth rate of P. calcareum from Northern Ireland at 10 m depth and under constant laboratory conditions was c. 0.9 mm yr(-1), double the rates observed at 5 m depth and in L. corallioides. Our measurements and re-examination of reported data allow us to conclude that the three most abundant maerl species in Europe grow about 1 (0.5-1.5) mm per tip per year under a wide range of field and artificial conditions. Internal banding in temperate European maerl revealed by SEM is a result of regular changes in wall thickness; the approximately monthly periodicity of bands in field-grown specimens is consistent with previous suggestions that they may be lunar. The potential for maerl banding to be a high-resolution record of palaeoclimatic and palaeoenvironmental change could be realized with this vital stain in conjunction with isotopic or microgeochemical analyses.