scholarly journals Drug Utilization Evaluation of Agents Administered for Prevention and Treatment of Cancer-Related Infections

2021 ◽  
Author(s):  
Mohammad Mohammadzadeh ◽  
Ebrahim Farashi ◽  
Amir Reza Hesam ◽  
Seyed Hadi Chavoshi ◽  
Saba Ghaffary
Keyword(s):  
Drug Utilization ◽  
Anatomical Therapeutic Chemical ◽  
Hematologic Malignancy ◽  
Critical Role ◽  
Antifungal Prophylaxis ◽  
Defined Daily Dose ◽  
Total Consumption ◽  
Defined Daily Doses ◽  
Bed Days ◽  
Drug Utilization Evaluation

Background: Due to the critical role of antibiotics and increasing trend of resistance in developing countries, comprehensive methods of antibiotic use is necessary to limit the threat of resistant microorganisms. In this study we compare antibiotics consumption by Defined Daily Dose (DDD) per 100 bed-days in Shahid Ghazi hospitals during three months in Tabriz, Iran. Methods: This is a retrospective study, which enrolled patients with malignancy who admitted to Shahid Ghazi hospital from January till March 2016. From all, 58 patients diagnosed with malignancy and received antibiotics for prophylaxis and/or treatment. For the purpose of Drug Utilization Evaluation (DUE) all antibiotics, antifungals and antiviruses consumption for any reason (prophylaxis, empiric therapy, targeted therapy) were recorded. Data on administered medications such as indication, duration, and dose were compared according to the guidelines of the NCCN 2.2016. The accuracy of antibiotics consumption was assessing by NCCN (2.2016) guideline. Anatomical Therapeutic Chemical (ATC) code J01 was explained as defined daily doses per 100 bed- days (DDD/100) according to the ATC/DDD classification. The amount of consumption was assessed with DDD per 100 bed-days in three months. Results: from 56 patients, 46 of them had hematologic malignancy and 10 of them had solid tumors. The indication of antibiotics and antifungal prophylaxis were wrong in 19.6% of indications. The prophylaxis dosage of antibiotics, antifungal, antiviral and PCP were wrong in 8.8%, 41.7%, 80% and 50%, respectively. The prophylaxis duration of antibiotics, antifungal, antiviral and PCP were wrong in 69.4%, 61.2%, 80% and 100% respectively. The dose adjustment of antibiotics with GFR and renal status of patients, in 8 of 9 patients (88.88%) who received meropenem, and in 9 of 23 patients (39.13%) who received imipenem, were not applicable according standard guidelines. The total consumption of systemic antibiotics in Ghazi Hospital during 3 months was 5091 (Table 7). From all patients 75% of them received antibiotics according to the ATC/DDD classification System. Conclusion: Specific strategies should be employed in infection control development and engage rational antibiotic utilization in order to reduce future resistant strains and increase anti-microbial efficacy.

scholarly journals DRUG UTILIZATION EVALUATION OF BENZODIAZEPINES IN A TERTIARY CARE HOSPITAL

2019 ◽  
pp. 6-9
Author(s):  
P. RAMA ◽  
R. MONISHA ◽  
SUSAN VARGHESE PAUL ◽  
VARSHA ELSA SCARIA ◽  
P. JANANI ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Anatomical Therapeutic Chemical ◽  
Low Cost ◽  
Tertiary Care ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Probability Scale ◽  
Related Information ◽  
A Prospective Study ◽  
Drug Utilization Evaluation

Objective: To assess the rationale use of benzodiazepines among various departments in a multi-speciality hospital. Methods: A prospective study was conducted with a sample size of 200 for a period of six months. Data was collected from patients based on inclusion and exclusion criteria. Naranjo Adverse Drug Reaction Probability Scale and Drug Interaction Probability Scale (DIPS) were used as a study tool to measure the causality of adverse drug reactions and drug interactions. Based on the dosage of various benzodiazepines DDD was calculated and compared with WHO Anatomical Therapeutic Chemical (ATC) classification Defined Daily Dose (DDD). Results: BZD’s were mostly prescribed in males (74.5%) and married patients (86.5%) were more exposed to benzodiazepines compared to others. Lorazepam (70.1%) was found to be the most commonly used drug, mainly prescribed for sedation, followed by anxiety. DDD was calculated and majority of patients had DDD in accordance with WHO standard. Based on cost analysis, Clobazam was found to be the high cost and Lorazepam being the low-cost drug. The results of drug utilization evaluation of benzodiazepines study were compiled and reported to the respected department physician and their feedback was collected. Conclusion: The study showed a rational utilization of benzodiazepines and the negative outcomes of BZDs can be reduced by providing drug-related information to the prescribers and consumers.

scholarly journals Assessment of drug utilization among geriatric patients based on defined daily dose concept in a rural tertiary care teaching hospital

2020 ◽  
Vol 9 (10) ◽  
pp. 1538
Author(s):  
K. Padmavathi ◽  
S. A. Arun Raaj ◽  
S. Subash ◽  
C. K. Dhanapal ◽  
S. Periasamy
Keyword(s):  
Drug Utilization ◽  
Geriatric Patients ◽  
Anatomical Therapeutic Chemical ◽  
Tertiary Care ◽  
Defined Daily Dose ◽  
College Hospital ◽  
Care Teaching ◽  
Essential Drug List ◽  
Daily Dose ◽  
Collection Form

Background: The objectives of the study were to use the anatomical therapeutic chemical classification (ATC) /defined daily dose (DDD) concept to study the drug utilization pattern in geriatric patients in a rural tertiary care teaching hospital.Methods: An observational study was conducted at Rajah Muthiah Medical College Hospital (OPD and IPD) over a period of six months from November 2018 to April 2019. The data was collected from 204 patients using specially designed data collection form. The patients were selected based on inclusion and exclusion criteria. Results: A total of 204 patients were included in this study. The study population consisting of males 130 (63.7%) and females 74 (36.2%). Diseases related to the cardiovascular system 67 (32.84%) were the most common cause for the geriatric patients to attend the hospital, followed by surgical diseases 47 (23.03%), Oncological diseases 2 (0.98%) were the least frequency encountered. The average number of drugs prescribed per prescription was 8.79. Out of 1795 drugs prescribed, 60.86% of drugs were prescribed in generic form, and 39.14% were prescribed in brand name. The study analysed that 71.25% of drugs prescribed were from essential drug list (EDL) 2016-2018. Number of prescriptions with an injection was 74.04%. Paracetamol (N02B01) was the most frequently prescribed drug, followed by Amlodipine (C08CA01), Dexamethasone (H02AB02), Clopidogrel (B01AC04), Ferrous sulfate (B03AA07), Acetylsalicylic acid (B01AC06), Hydrocortisone (H02AB09), Tamsulosin (G04CA02), Atorvastatin (C10AA05), Furosemide (C03CA01).Conclusions: Drug utilization study can help in evaluating the quality of care given to the geriatric patients and promote rational use of medicines.

scholarly journals Trends of Adult Antimicrobial Hospital Consumption in Catalonia (Spain) from 2008 to 2018

2020 ◽  
Vol 41 (S1) ◽  
pp. s500-s501
Author(s):  
Santiago Grau ◽  
Sergi Hernández ◽  
Ariadna Padullés ◽  
Montserrat Gimenez ◽  
Lucía Boix-Palop ◽  
...  
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
Pearson Correlation ◽  
Acute Care Hospital ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Antimicrobial Consumption ◽  
Surgical Units ◽  
Amoxicillin Clavulanate ◽  
Bed Days ◽  
Hospital Consumption

Background: Antimicrobial resistance is a disturbing problem in the health system. A relationship between the use of certain antimicrobials and a resistance increase has been proposed. Since this phenomenon is not usually attributed to specific uses of antimicrobials but preferably to its evolution over the years, the analysis of the antimicrobial consumption over time can justify the epidemiological situation of a given region in terms of resistance and possible increases and decreases for specific microorganisms. The objective of this study was to analyze the evolution of the use of antimicrobials in Catalonia during 2008–2018 through the VINCat program (Infection Control and Antimicrobial Stewardship Catalonian Program). Methods: The number of hospitals participating in the VINCat increased from 46 in 2008 to 63 in 2018 (ie, 68.8% and 85.7% of all adult acute-care hospital beds in Catalonia, respectively). Hospitalization days recorded at the participating hospitals increased from 2,991,053 in 2008 to 3,714,938 in 2018. The Anatomical Therapeutic Chemical Classification (ATC) defined daily dose (DDD) index was used for monitoring antimicrobial consumption. Simple linear regressions were performed, the linear relationship was checked by ANOVA tests, and the Pearson correlation (Pc) coefficients were obtained. Values of P ≤ .05 were considered statistically significant. Results: From 2008 to 2018, there was a statistically significant increase of global antibacterial consumption (65.50 vs 71.73 DDD per 100 bed days; P = .001) and antimycotic consumption (3.09 vs 3.45 DDD per 100 bed days, P = .012) due to an increase of consumption in the surgical units. At the same time, there was a decrease in the consumption of antimycotics in the medical units (4.35 vs 3.90 DDD per 100 bed days; P =.029). Cephalosporins and carbapenem consumption increased both globally (10.88 vs 13.86 DDD per 100 bed days; P < .001) and in medical and surgical units (3.26 vs 5.38 DDD per 100 bed days; P < .001). This increase was mainly associated with ceftriaxone (3.45 vs 5.46 DDD per 100 bed days; P < .001) and meropenem (1.12 vs 3.08 DDD per 100 bed days; P < .001). There was a global decrease in the consumption of penicillins (26.10 vs 24.24 DDD per 100 bed days; P = .012) and quinolones (11.63 vs 9.61 DDD per 100 bed days; P = .004). This trend was observed also in ICUs and medical units but not in surgical units, for which only quinolones showed a significant decrease. Decreases in the use of amoxicillin/clavulanate acid (17.80 vs 14.24 DDD per 100 bed days; P < .001) and ciprofloxacin (5.68 vs 4.01 DDD per 100 bed days; P < .001) were observed. Conclusions: The increase in the use of antimicrobials in Catalonia is concerning. This increase is attributable to the use of these drugs in surgical units. Antibiotic stewardship measures should be aimed primarily at these units. The increasing use of carbapenems should be analyzed.Funding: NoneDisclosures: Juan Pablo Horcajada reports consulting fees from MSD, Pfizer, and Menarini as well as speaker honoraria from MSD, Pfizer, and Zambon.

scholarly journals Analyzing Antidiabetes Drug Prescriptions With World Health Organization Anatomical Therapeutic Chemical/Defined Daily Dose Index to Assess Drug Utilization Pattern in Elderly Population of Rural Eastern India

2017 ◽  
Vol 8 ◽  
pp. 117739361770334 ◽  
Author(s):  
Sandeep Lahiry ◽  
Avijit Kundu ◽  
Ayan Mukherjee ◽  
Shouvik Choudhury ◽  
Rajasree Sinha
Keyword(s):  
World Health Organization ◽  
Drug Utilization ◽  
West Bengal ◽  
Anatomical Therapeutic Chemical ◽  
World Health ◽  
Defined Daily Dose ◽  
Prescription Data ◽  
Daily Dose ◽  
Health Organization

Objective: To analyze drug utilization (DU) pattern of antidiabetes drug (ADD) prescription in elderly type 2 diabetes mellitus (T2DM) in rural West Bengal based on 2016 World Health Organization (WHO) Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) Index. Methods: This was a prospective observational study. Prescription data of 600 elderly patients (age > 60 years) attending outpatient clinic were screened over 12 months (January 2015 to January 2016) from 5 different rural hospitals in West Bengal. Pooled data were sorted and classified in accordance with 2016 ATC/DDD WHO Index. Direct cost associated and consumption of ADD were measured as DDD/1000 patients/day. The adverse drug reactions (ADRs) related to antidiabetic medicines were monitored. Results: During the study period, mean age of patients recorded was 66.4 ± 5.0 years, with 66.6% (n = 396) having history of T2DM > 5 years. Follow-up encounters (n = 2328) revealed metformin (94.67%), sulfonylureas (SUs) (50.54%), pioglitazone (24.22%), voglibose (22.50%), insulin (9.75%), and acarbose (6.82%) to be more prevalent, constituting DU 90% (92.01%). Combination of metformin plus SU was recorded in most of the patients (56%). Insulin, however, was found to be an underutilized class ( P < .005). The DDD/1000 patients/day of metformin (2.918), glimepiride (1.577), and gliclazide (0.069) conformed to 2016 WHO ATC/DDD Index. The total ADD consumption during study period was 5.03 DDD/1000 patients/day. The average drug cost per encounter per day was Rs 11.24 ± 2.01. Nineteen ADRs were reported and their descriptions were found to be of hypoglycemia (n = 9), pedal edema (n = 2), and gastrointestinal upsets (n = 8). Target glycemic status was achieved in 40% monthly follow-up encounters. Low-store drug availability and poor compliance to treatment (>60%) were major determinants. Lack of regular aerobic exercises (>85%) and proper knowledge regarding medical nutrition therapy (MNT) (>80%) and low average consultation time (3.5 ± 0.6 minutes) were important contributing factors. Conclusions: The study exhibited increased utilization of 2 drug combinations of oral ADD and lower utilization of insulin during study period. Such inferences merit further exploration.

scholarly journals Drug utilization pattern among geriatrics according to anatomical therapeutic chemical and defined daily dose classification in a tertiary care hospital

2019 ◽  
Vol 8 (9) ◽  
pp. 1989
Author(s):  
T. Muneswar Reddy ◽  
Thammi Setty Durga Prasad ◽  
Allikesam Hemalatha ◽  
Vanam Chanukya ◽  
Bandi Lakshmi Sirisha
Keyword(s):  
Drug Utilization ◽  
Anatomical Therapeutic Chemical ◽  
Tertiary Care ◽  
Essential Medicines ◽  
World Health ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Utilization Pattern ◽  
Geriatric Population ◽  
Daily Dose

Background: This study was conducted to determine the drug utilization pattern among geriatric inpatients in general medicine department of the hospital.Methods: An observational, prospective study was conducted for a period of six months (November 2016 to April 2017) among 200 geriatric patients; demographic details, education, occupation, diagnosis and drug details were recorded. The drugs were categorized by anatomical therapeutic classification (ATC) and defined daily dose (DDD) was calculated. The World Health Organization (WHO) prescribing indicators were assessed.Results: The majority of the patients (59%) were in age group of 60-69 years. Cardiovascular diseases were common among geriatrics. Most commonly prescribed drug was Pantoprazole (81.7%). Drugs were assigned with ATC/DDD codes according to the guidelines of WHO. Drugs prescribed by their generic names were 56.64% and 43% of drugs that were included in the National Essential Medicines List.Conclusions: Clinical pharmacist have to collaborate and work together with physicians in selecting and adjusting the dose among geriatric population in order to reduce development of potential adverse drug reactions, serious drug related complications and drug interaction.

scholarly journals Antibiotic use on paediatric inpatients in a public hospital in Bangil, Indonesia

2021 ◽  
pp. 163-167
Author(s):  
Ika Norcahyanti ◽  
Malikatur Rosyidah ◽  
Abdul Kadir Jaelani ◽  
Antonius N.W. Pratama
Keyword(s):  
Public Hospital ◽  
Anatomical Therapeutic Chemical ◽  
Action Plan ◽  
Antibiotic Use ◽  
Defined Daily Dose ◽  
Cross Sectional ◽  
Pediatric Ward ◽  
Global Action ◽  
Bed Days ◽  
Cross Sectional Design

Introduction: The importance of antibiotic use in a clinical setting was evaluated in order to support the global action plan to decelerate the spreading speed of antimicrobial resistance. Objective: This study aimed to evaluate antibiotic use among pediatric inpatients in Bangil public hospital, East Java, Indonesia. Methods: This study used a cross-sectional design. The data were obtained from medical records of pediatric patients admitted to a pediatric ward in 2017. Data were analysed using the anatomical therapeutic chemical classification system (ATC)/defined daily dose (DDD) method in conjunction with data sources from a locally developed bacterial map. Results: The results showed the paediatric patients were dominantly male (n=218; 54.2%) and mostly diagnosed with diarrhoea (n=87; 15.3%). Ampicillin-sulbactam was the most commonly used antibiotic (16.3%). The total DDD value was 66.1 DDD/100 bed-days, and ceftriaxone demonstrated the highest DDD value (10.3 DDD/100 bed-days). Conclusion: In conclusion, the use of antibiotics in the pediatric ward in Bangil public hospital was comparable to other studies conducted in Indonesia.

scholarly journals Variations in the Consumption of Antimicrobial Medicines in the European Region, 2014–2018: Findings and Implications from ESAC-Net and WHO Europe

2021 ◽  
Vol 12 ◽  
Author(s):  
Jane Robertson ◽  
Vera Vlahović-Palčevski ◽  
Kotoji Iwamoto ◽  
Liselotte Diaz Högberg ◽  
Brian Godman ◽  
...  
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
Antibiotic Consumption ◽  
Study Group ◽  
Defined Daily Dose ◽  
European Economic Area ◽  
The European Union ◽  
Weighted Mean ◽  
Total Consumption ◽  
Regional Office ◽  
Relative Population

Background: Surveillance of antimicrobial consumption (AMC) is important to address inappropriate use. AMC data for countries in the European Union (EU) and European Economic Area (EEA) and Eastern European and Central Asian countries were compared to provide future guidance.Methods: Analyses of 2014–2018 data from 30 EU/EEA countries of the European Surveillance of Antibiotic Consumption network (ESAC-Net) and 15 countries of the WHO Regional Office for Europe (WHO Europe) AMC Network were conducted using the Anatomical Therapeutic Chemical (ATC) classification and Defined Daily Dose (DDD) methodology. Total consumption (DDD per 1000 inhabitants per day) of antibacterials for systemic use (ATC group J01), relative use (percentages), trends over time, alignment with the WHO Access, Watch, Reserve (AWaRe) classification, concordance with the WHO global indicator (60% of total consumption should be Access agents), and composition of the drug utilization 75% (DU75%) were calculated.Findings: In 2018, total consumption of antibacterials for systemic use (ATC J01) ranged from 8.9 to 34.1 DDD per 1000 inhabitants per day (population-weighted mean for ESAC-Net 20.0, WHO Europe AMC Network 19.6, ESAC-Net Study Group, and WHO Europe AMC Network Study Group). ESAC-Net countries consumed more penicillins (J01C; 8.7 versus 6.3 DDD per 1000 inhabitants per day), more tetracyclines (J01A; 2.2 versus 1.2), less cephalosporins (J01D; 2.3 versus 3.8) and less quinolones (J01M; 1.7 versus 3.4) than WHO Europe AMC Network countries. Between 2014 and 2018, there were statistically significant reductions in total consumption in eight ESAC-Net countries. In 2018, the relative population-weighted mean consumption of Access agents was 57.9% for ESAC-Net and 47.4% for the WHO Europe AMC Network. For each year during 2014–2018, 14 ESAC-Net and one WHO Europe AMC Network countries met the WHO global monitoring target of 60% of total consumption being Access agents. DU75% analyses showed differences in the choices of agents in the two networks.Interpretation: Although total consumption of antibacterials for systemic use was similar in the two networks, the composition of agents varied substantially. The greater consumption of Watch group agents in WHO Europe AMC Network countries suggests opportunities for improved prescribing. Significant decreases in consumption in several ESAC-Net countries illustrate the value of sustained actions to address antimicrobial resistance.

scholarly journals Prescription-only drugs in Banja Luka region: Utilization analysis

2004 ◽  
Vol 57 (1-2) ◽  
pp. 72-76 ◽  
Author(s):  
Natasa Stojakovic ◽  
Ranko Skrbic ◽  
Svjetlana Stoisavljevic-Satara ◽  
Dragana Babic-Djuric ◽  
Lana Nezic ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Anatomical Therapeutic Chemical ◽  
Central City ◽  
Cardiovascular Drugs ◽  
Insurance Fund ◽  
Defined Daily Dose ◽  
Epidemiological Analysis ◽  
Daily Dose ◽  
Total Analysis ◽  
Banja Luka

Introduction Using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology, we analyzed utilization of prescription-only drugs in Banja Luka region in 2000 - 2001. Material and methods A retrospective study on drug utilization, according to ATC classification, was conducted on the basis of data received from Central City Pharmacy Banja Luka, and results were presented in terms of DDD/1000 inhabitants/day. Results Pharmaco-epidemiological analysis showed that the list of 20 most frequently prescribed drugs in 2000 included 8 cardiovascular drugs and 6 anti-infective drugs. In 2001, 20 most frequently prescribed drugs, included 9 cardiovascular drugs, and 4 anti-infective drugs. Regarding anti-infective agents, the most frequently prescribed antibiotics were amoxicillin, doxycyline, co-trimoxazole and gentamicin. The most frequently prescribed drug in 2000 was diazepam (5,33 DDD/1000 inhabitants/day). The use of this drug significantly increased in 2001 (7,95 DDD/1000 inhabitants/day). Discussion and conclusion Based on total analysis, it can be concluded that the positive drug list, defined by the Health Insurance Fund, significantly affected the drug utilization profile, but some drugs are considered to be irrationally prescribed.

scholarly journals Comparative analysis of antipsychotic drug consumption for inpatient schizophrenia treatment: a retrospective study with 5-year follow-up

2020 ◽  
Vol 13 (3) ◽  
pp. 251-261
Author(s):  
L. B. Vaskova ◽  
M. V. Tiapkina ◽  
E. V. Mikhaylenko
Keyword(s):  
Antipsychotic Drugs ◽  
Demographic Data ◽  
Paranoid Schizophrenia ◽  
Psychiatric Inpatient ◽  
Defined Daily Dose ◽  
Total Consumption ◽  
Duration Of Hospitalization ◽  
Icd 10 ◽  
Bed Days

Aim. The study was aimed to perform a comparative retrospective pharmacoepidemiological analysis of antipsychotic drugs (APD) used for inpatient treatment for schizophrenia.Materials and methods. This retrospective pharmacoepidemiological study included 1077 medical records of patients diagnosed with schizophrenia according to ICD-10 (F20.0-F20.8) selected for the analysis on the base of a psychiatric inpatient hospital in Moscow during 2013-2017. The study design included socio-demographic data (sex, age, education, disability, social status) and clinical-economic data (diagnoses, duration of hospitalization), information on the prescription frequency of drugs and dose regimens were analyzed. The consumption volume of APD was estimated using the WHO ATS/DDD methodology.Results and discussion. It was found that women prevailed (55-71%) with the mean age ranging from 42.8±14.1 to 47.4±14.7 (±SD – standard deviation). In the studied sampling, paranoid schizophrenia dominated (≥70%). Over the analyzed 5-year period, the consumption volume of APDs was characterized by alternating declines and rises (from 154.49 to 208.09 NDDD/100 bed-days). The consumption of atypical APDs decreased by 7% and typical APDs increased by 25% compared to the base year (2013), respectively. The most significant changes in the consumption were identified for APDs of prolonged action (a decrease by 67% compared to 2013). Haloperidol and clozapine (oral forms), which are included in the DU90% segment, remained the leaders in terms of prescription frequency and consumption volume (49.04 and 45.26 NDDD/100 bed days in 2017, respectively). Moreover, trihexiphenydil (used to correct adverse reactions) also had a high frequency of administration and consumption.Conclusion. It was found that 1/2 of all prescriptions were antipsychotic drugs used to treat schizophrenia. The total consumption volume of APDs in 2017 decreased by 9.2% compared to 2013. A high consumption volume is typical for drugs from the subgroup of typical APDs, but atypical APDs prevailed in terms of prescription frequency, which may indicate the prescription of typical APDs in doses exceeding the defined daily dose.

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