scholarly journals Analysis of the antibiotic consumption on the backdrop of the COVID-19 pandemic: hospital level

2021 ◽  
pp. 118-128
Author(s):  
K. I. Karnoukh ◽  
N. B. Lazareva
Keyword(s):  
Antibiotic Resistance ◽  
Medical Records ◽  
Antibiotic Consumption ◽  
Rational Approach ◽  
City Hospital ◽  
Total Consumption ◽  
Negative Contribution ◽  
Antibacterial Drugs ◽  
Moscow City ◽  
Bed Days

Introduction. According to available data, the frequency of prescribing antibacterial drugs to patients hospitalized with COVID-19 is many times higher than the level of bacterial infection recorded in them. This trend may make an extremely negative contribution to the problem of antibiotic resistance in the future, which makes it important to monitor and study the consumption of antibiotics in this category of patients.Aim of the study. To estimate the change in the consumption of antibacterial drugs in patients hospitalized with COVID-19 in a multidisciplinary hospital compared with the consumption in the pre-pandemic period, and to conduct a subsequent analysis of the detected changes.Materials and methods. This retrospective study, reviewed the medical records of patients hospitalized with COVID-19 in the Moscow city hospital No. 4 in the period from April 27 to December 31, 2020, as well as medical records of patients hospitalized in the same medical institution for the same period of 2019. Results of the use of antibacterial drugs were obtained. They were evaluated using the ATC/DDD methodology and then subjected to further analysis.Results. Total consumption increased from 31,576 DDD/100 bed-days to 220,609 DDD/100 bed-days among the patients hospitalized with COVID-19. The level of consumption of macrolides increased most significantly – from 0.024 DDD/100 bed-days to 147.898 DDD/100 bed-days. The level of consumption of penicillins increased from 2,346 DDD/100 bed-days to 15,892 DDD/100 beddays, cephalosporins – from 11.78 DDD/100 bed-days to 19,107 DDD/100 bed-days, fluoroquinolones – from 10,276 DDD/100 beddays to 25,535 DDD/100 bed-days.Conclusion. The consumption of antibiotics has increased dramatically on the backdrop of the COVID-19 pandemic. Based on the data of the frequency of bacterial complications in patients with COVID-19 (no more than 8%), a more rational approach to antibacterial therapy in this group of patients is needed to reduce the potential deterioration of the problem of antibiotic resistance.

scholarly journals Improving the Rational Use of Medicines by Assessing Antibiotic Consumption to Solve the Problem of Antibiotic Resistance in the Republic of Kazakhstan

2021 ◽  
pp. 31-35
Author(s):  
Gulzira Zhussupova ◽  
◽  
Saule Zhaldybayeva ◽  
Aiym Skakova ◽  
◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Infections ◽  
Antibiotic Consumption ◽  
Policy Option ◽  
Policy Options ◽  
Self Medication ◽  
Antibacterial Drugs ◽  
Rational Use ◽  
Rational Use Of Medicines ◽  
The Republic

The aim. Develop policy options to improve the rational use of medicines by assessing antibiotic consumption to address antibiotic resistance in the Republic of Kazakhstan. We used the data of the Republican Center for Healthcare Development’s report on the assessment of the consumption of antibiotics in the Republic of Kazakhstan, purchased by the Single Distributor within the guaranteed volume of free medical care for 2019, in comparison with the period 2017-2018. Three policy options have been developed: 1. Improving the rational prescription and use of antibacterial drugs. 2. Raising awareness and understanding of antimicrobial resistance issues through information policy and increased training 3. Strengthening control of prescription dispensing of antibacterial drugs in pharmacies. For each policy option, measures are identified to achieve them, as well as possible barriers. A combined implementation of each policy option is necessary, as this issue requires a systematic approach. The implementation of all points of measures will contribute to ensuring the use of antibacterials rationally, according to strict therapeutic indications, with an individual selection of dosages and will exclude self-medication with antibiotics, which in turn will help prevent antibiotic resistance in the future and will give a chance for effective, high-quality and successful treatment of bacterial infections. Key words: medicines, systemic antibiotics, consumption of antibiotics, antibiotic resistance, rational use of medicines, Kazakhstan.

scholarly journals ANTIBIOTIC USE IN SLOVENIAN HOSPITALS

2020 ◽  
Vol 7 (11) ◽  
pp. 249-258
Author(s):  
Tatjana Pokrajac ◽  
Milan Čižman ◽  
Bojana Beovič
Keyword(s):  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Defined Daily Dose ◽  
Total Consumption ◽  
Test Analysis ◽  
Weighted Linear Regression ◽  
Case Mix Index ◽  
Regression Test ◽  
Daily Dose ◽  
Bed Days

Abstract: Motivation/Background: Antibiotics are commonly overused and misused what increase the emergence of resistant organisms, side- effects and costs. To assess the appropriate use of antibiotics many methods are available. The aim of the present study is to find correlation between antibiotic use and case mix index (CMI) in Slovenian hospitals. Method: In retrospective study (in the years between 2004 and 2013) we correlated the total consumption of antibiotics for systemic use and CMI. Weighted linear regression test analysis was performed to determine correlation between defined daily dose (DDD) / 100 admissions and DDD / 100 bed-days and CMI. Results: The total antibiotic consumption in all included hospitals was in mean 317.69 DDD / 100 admissions and 58.88 DDD / 100 bed days, respectively. CMI range were from 1.25 to 3.55. A significant correlation between consumption expressed in DDD / 100 admissions and CMI (p = 0.028) and DDD / 100 bed days and CMI (p =0.008) was found. Conclusions: Thus, detailed analysis of correlations between DDD of antibiotics and CMI may constitutes a proper use of antibiotics.

scholarly journals Measurement of antibiotic consumption in surgical ward of a tertiary care hospital

2020 ◽  
Vol 9 (10) ◽  
pp. 1565
Author(s):  
Rashmi R. Pujari ◽  
Bhabagrahi Rath ◽  
Tapan Kumar Nayak
Keyword(s):  
Antibiotic Resistance ◽  
Average Length ◽  
Tertiary Care ◽  
Medical Science ◽  
Antibiotic Consumption ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Number Of Patients ◽  
Improper Use ◽  
Bed Days

Background: Antibiotic resistance is a global health problem. Improper use of antibiotics leads to development of antibiotic resistance, side effects, superinfections and increase in treatment costs. There are few publications on antibiotic consumption. Serious morbidity and mortality are associated with postoperative wound infections. The use of peri or pre-operative antibiotics has resulted in a reduced risk of postoperative infection when appropriate principles of prophylaxis are applied.Methods: An observational study during a 2-month period was carried out in the department of surgery of Veer Surendra Sai Institute of Medical Science and Research, Burla. We utilized the administrative data for expression of antibiotic consumption using anatomical therapeutic classification (ATC) / defined daily dose (DDDs) methodology. The information included were drug names, strength, pharmaceutical form, quantity dispensed, total number of patients admitted during the study period and average length of stay. Each drug was then given a code according to the ATC classification. The number of DDDs and DDDs/100 bed days was calculated.Results: The most frequent antibiotic used was cephalosporin group with DDDs 62.70 DDDs/100 bed days (44.34%) followed by metronidazole with 23.10 DDDs/100 bed days (16.34%). Among cephalosporin group most common antibiotic used was ceftriaxone with 24.46 DDDs/100 bed days. The mean duration of stay was 7.2 days.Conclusions: The results of this study are similar to previous studies and it showed that there is irrational use of antibiotics as there is no antibiotic policy in our hospital. Drug utilization research should be carried out at frequent intervals to improve rational use of antibiotics.

scholarly journals Antibiotic Consumption and Resistance Pattern of 3 Coagulase-Negative Staphylococci Species: An Ecological Study

2021 ◽  
pp. 251-257
Author(s):  
Herleeyana Meriyani ◽  
Dwi Arymbhi Sanjaya ◽  
Ketut Agus Adrianta
Keyword(s):  
Antibiotic Resistance ◽  
Ecological Study ◽  
Secondary Data ◽  
Antibiotic Consumption ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Coagulase Negative Staphylococci ◽  
Disk Diffusion Method ◽  
Factors Affecting ◽  
Bed Days

A group of coagulase-negative staphylococci (CoNS) was historically classified as a nonpathogenic bacteria. Over the last few decades, nosocomial infections caused by CoNS as opportunistic pathogens have increased and become one of the major nosocomial pathogens. The aim of this study was to identify the relationship between the use of an antibiotic agent for CoNS in Bali’s regional public hospital and the development of antibiotic resistance during 3 years period. This study was a retrospective ecological study of antibiotic resistance and antibiotic consumption secondary data collected prospectively. It was conducted over a three years period of inpatient data. Susceptibility of CoNS to antibiotics was obtained from the hospital antibiogram of all isolates from 2017 to 2019. Sensitivity results in antibiogram were based on the standards provided by the Clinical and Laboratory Standards Institute (CLSI) with the disk diffusion method. Antibiotic consumption in DDDs/100 bed-days. The relationships between DDDs/100 bed-days of each antibiotic and rates of antibiotic resistance of each resistant strain of CoNS were tested using Spearman correlation and logistic regression. There was no significant correlation between antibiotic consumption (DDD) and the percentage of antibiotic resistance among the three CoNS species (p>0.05). However, this study found there was an inverse relationship between DDD and antibiotic resistance in Staphylococcus hominis species (OR = 0.063; CI [0.004-0.915]; p=0.043). We conclude that no significant correlation between antibiotic consumption and antibiotic resistance of the 3 CoNS species. There needs to be further research to identify antibiotic consumption, antibiotic resistance and other factors affecting antibiotic resistance.

scholarly journals National Antibiotic Consumption for Human Use in Sierra Leone (2017–2019): A Cross-Sectional Study

2021 ◽  
Vol 6 (2) ◽  
pp. 77
Author(s):  
Joseph Sam Kanu ◽  
Mohammed Khogali ◽  
Katrina Hann ◽  
Wenjing Tao ◽  
Shuwary Barlatt ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Antibiotic Consumption ◽  
Cross Sectional Study ◽  
Defined Daily Dose ◽  
Oral Antibiotics ◽  
Sectional Study ◽  
Beta Lactam ◽  
Total Consumption ◽  
Cross Sectional ◽  
Procaine Penicillin

Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, currently there is no system in Sierra Leone for recording and reporting on antibiotic consumption. We therefore conducted a cross-sectional study to assess national antibiotic consumption expressed as defined daily dose (DDD) per 1000 inhabitants per day using all registered and imported antibiotics (categorized under the subgroup J01 under the anatomical and therapeutic classification (ATC) system) as a proxy. Between 2017–2019, total cumulative consumption of antibiotics was 19 DDD per 1000 inhabitants per day. The vast majority consisted of oral antibiotics (98.4%), while parenteral antibiotics made up 1.6%. According to therapeutic/pharmacological subgroups (ATC level 3), beta-lactam/penicillins, quinolones, and other antibacterials (mainly oral metronidazole) comprised 65% of total consumption. According to WHO Access, Watch, and Reserve (AWaRe), 65% of antibiotics consumed were Access, 31% were Watch, and no Reserve antibiotics were reported. The top ten oral antibiotics represented 97% of total oral antibiotics consumed, with metronidazole (35%) and ciprofloxacin (15%) together constituting half of the total. Of parenteral antibiotics consumed, procaine penicillin (32%) and ceftriaxone (19%) together comprised half of the total. Policy recommendations at global and national levels have been made to improve monitoring of antibiotic consumption and antibiotic stewardship.

A Retrospective Study of Treatment Outcome for Patients With Non-Insulin-Dependent Diabetes at an Inner-City Hospital

1995 ◽  
Vol 21 (2) ◽  
pp. 113-116
Author(s):  
Wissam E. Nadra ◽  
Eric L. Knight ◽  
Martha B. Lee ◽  
Woerner P. Meehan
Keyword(s):  
Metabolic Control ◽  
Plasma Glucose ◽  
Medical Records ◽  
Total Population ◽  
Good Control ◽  
Insulin Dependent Diabetes ◽  
City Hospital ◽  
Patients With Diabetes ◽  
Insulin Dependent

The medical records of 173 consecutive patients with diabetes who were newly enrolled in our facility in 1990 were analyzed for blood glucose at 1 year. A total of 81 females and 72 males with non-insulin-dependent diabetes were studied. With regard to overall compliance in keeping clinic appointments, 56 (36.6%) patients were still coming in for follow-up I year after the diagnosis of diabetes versus 97 (63.4%) patients who had stopped coming in. Overall, 70 (45.8%) patients had a plasma glucose > 180 mg/dL and had not achieved metabolic control, and 83 (54.2%) patients had a plasma glucose≤180 mg/dL and had achieved good metabolic control at their last visit. Most patients with good control (58/153, 69.9%) had stopped coming in by the end of 1 year. Only 25 patients with plasma glucose ≤180 mg/dL were still coming in for follow-up visits, representing the smallest percentage (16.3%) of the total population studied. At I year there also was a correlation between increased body weight and improved glycemic control.

scholarly journals Staphylococcus aureus - selective reporting of antibiogram results and its impact on antibiotic use: Interventional study with a reference group on the effect of switching from non-selective to selective antibiotic reporting

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Franka Lestin-Bernstein ◽  
Ramona Harberg ◽  
Ingo Schumacher ◽  
Lutz Briedigkeit ◽  
Oliver Heese ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Selective Reporting ◽  
Beta Lactams ◽  
Interventional Study ◽  
Patient Level ◽  
Narrow Spectrum ◽  
Bed Days ◽  
The Impact

Abstract Background Antimicrobial stewardship (AMS) strategies worldwide focus on optimising the use of antibiotics. Selective susceptibility reporting is recommended as an effective AMS tool although there is a lack of representative studies investigating the impact of selective susceptibility reporting on antibiotic use. The aim of this study was to investigate the impact of selective susceptibility reporting of Staphylococcus aureus (S. aureus) on antibiotic consumption. Enhancing the use of narrow-spectrum beta-lactam antibiotics such as flucloxacillin/cefazolin/cefalexin is one of the main goals in optimising antibiotic therapy of S. aureus infections. Methods This interventional study with control group was conducted at a tertiary care hospital in Germany. During the one-year interventional period susceptibility reports for all methicillin-sensitive S. aureus (MSSA) were restricted to flucloxacillin/cefazolin/cefalexin, trimethoprim-sulfamethoxazole, clindamycin, gentamicin and rifampin/fosfomycin, instead of reporting all tested antibiotics. The impact of implementing selective reporting was analysed by monitoring total monthly antibiotic consumption in our hospital and in a reference hospital (recommended daily dose/100 occupied bed days: RDD/100 BD), as well as on an individual patient level by analysing days of therapy adjusted for bed days (DOT/ 100 BD) for patients with S. aureus bacteremia (SAB) and respectively skin and soft tissue infections (SSTI). Results MSSA-antibiograms were acquired for 2836 patients. The total use of narrow-spectrum beta-lactams more than doubled after implementing selective reporting (from 1.2 to 2.8 RDD/100 BD, P < 0.001). The use of intravenous flucloxacillin/cefazolin for SAB rose significantly from 52 to 75 DOT/100 BD (plus 42%), just as the use of oral cefalexin for SSTI (from 1.4 to 9.4 DOT/100 BD, from 3 to 17 of 85/88 patients). Considering the overall consumption, there was no decrease in antibiotics omitted from the antibiogram. This was probably due to their wide use for other infections. Conclusions As narrow-spectrum beta-lactams are not widely used for other infections, their increase in the overall consumption of the entire hospital was a strong indicator that selective reporting guided clinicians to an optimised antibiotic therapy of S. aureus infections. On a patient level, this assumption was verified by a significant improved treatment of S. aureus infections in the subgroups of SAB and SSTI. As useful AMS tool, we recommend implementing selective reporting rules into the national/international standards for susceptibility reporting.

scholarly journals Risk-adjusted antibiotic consumption in 34 public acute hospitals in Ireland, 2006 to 2014

2016 ◽  
Vol 21 (32) ◽  
Author(s):  
Ajay Oza ◽  
Fionnuala Donohue ◽  
Howard Johnson ◽  
Robert Cunney
Keyword(s):  
Administrative Data ◽  
Risk Adjustment ◽  
Antibiotic Consumption ◽  
Factors Affecting ◽  
Defined Daily Doses ◽  
Acute Hospitals ◽  
Consumption Rates ◽  
Hospital Antibiotic Consumption ◽  
Bed Days ◽  
The Impact

As antibiotic consumption rates between hospitals can vary depending on the characteristics of the patients treated, risk-adjustment that compensates for the patient-based variation is required to assess the impact of any stewardship measures. The aim of this study was to investigate the usefulness of patient-based administrative data variables for adjusting aggregate hospital antibiotic consumption rates. Data on total inpatient antibiotics and six broad subclasses were sourced from 34 acute hospitals from 2006 to 2014. Aggregate annual patient administration data were divided into explanatory variables, including major diagnostic categories, for each hospital. Multivariable regression models were used to identify factors affecting antibiotic consumption. Coefficient of variation of the root mean squared errors (CV-RMSE) for the total antibiotic usage model was very good (11%), however, the value for two of the models was poor (> 30%). The overall inpatient antibiotic consumption increased from 82.5 defined daily doses (DDD)/100 bed-days used in 2006 to 89.2 DDD/100 bed-days used in 2014; the increase was not significant after risk-adjustment. During the same period, consumption of carbapenems increased significantly, while usage of fluoroquinolones decreased. In conclusion, patient-based administrative data variables are useful for adjusting hospital antibiotic consumption rates, although additional variables should also be employed.

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