Surveillance of antibiotic use.

To the Editor.— In a recent issue ofThe Journal(1979;242:2585), Latorraca and Martins described an ongoing system that provides total concurrent review of antibiotic use and hospital infections. The questions that the system addresses seem well defined, and the data collection forms are simply constructed to provide essential information. This appears to be a system that easily could be used by other community hospitals. Although the article mentions an improvement in medical care and a decrease of costs for antimicrobials since the institution of the system, the data presented by the article do not clearly support a decrease in use of antimicrobials. Table 2 in their article shows a decrease in overall use from January (40.5%) to December (29.5%), but the major decrease was between January (40.5%) and February (31.2%). By looking at their Table 3, which shows the percentage of community-acquired respiratory tract infections, it is apparent that