scholarly journals Surveilans Retrospektif Penggunaan Antibiotik Pada Pasien Anak Dengan Luka Bakar

2021 ◽  
Vol 7 (1) ◽  
pp. 21-28
Author(s):  
Okix Oki Nugraha Putra ◽  
◽  
Iswinarno D. Saputro ◽  
Hardiana D. Nurhalisa ◽  
Erma Yuliana ◽  
...  
Keyword(s):  
Defined Daily Dose ◽  
Daily Dose

Luka bakar merupakan salah satu bentuk trauma dengan tingkat risiko infeksi yang tinggi. Modalitas utama pada infeksi akibat luka bakar ialah pemberian antibiotik. Tujuan penelitian ini ialah untuk mengevaluasi penggunaan antibiotik pada pasien luka bakar anak secara kualitatif menggunakan metode Gyssens dan secara kuantitatif menggunakan metode ATC/defined daily dose (DDD). Pengambilan data dilakukan secara retrospektif melalui data rekam medik pasien luka bakar anak yang memenuhi kriteria inklusi yang dirawat di RSUD Dr. Soetomo pada tahun 2017-2019. Data diambil pada bulan November 2019 hingga Maret 2020. Didapatkan 18 pasien luka bakar anak yang memenuhi kategori inklusi. Antibiotik terbanyak yang digunakan pada penelitian ini yaitu ceftazidime sebesar 64,28%. Berdasarkan metode Gyssens didapatkan 27,77% antibiotik berada dalam kategori sudah sesuai dan sisanya termasuk dalam kategori kurang tepat dengan 84,6% termasuk kategori IIa (tidak tepat dosis) dan 15,4% termasuk kategori IVa (antibiotik lain yang lebih efektif). Berdasarkan metode ATC DDD, didapatkan nilai total DDD /100 patients-days sebesar 88,92 DDD/100patient-days dengan ceftazidime merupakan antibiotik dengan nilai terbesar yaitu 23,03 DDD/100 patient-days. Jenis antibiotik yang termasuk dalam DU 90% adalah ceftazidime (23,03), ampicillin-sulbactam (15,45), ceftriaxon (13,65), amikacin (11,91), gentamicin (9,67) dan meropenem (8,51). Kesimpulannya ialah secara kualitatif penggunaan antibiotik pada pasien luka bakar anak masih kurang sesuai dan secara kuantitatif penggunaan antibiotik melebihi standar WHO. Diperlukan perbaikan dalam rangka meningkatkan rasionalitas penggunaan antibiotik pada pasien luka bakar anak. Kata Kunci: Antibiotik, Luka Bakar, Anak, Gyssens, Defined Daily Dose

Comparison of the defined daily dose and days of treatment methods for evaluating the consumption of antibiotics and antifungals in the intensive care unit

2020 ◽  
Vol 44 (5) ◽  
pp. 294-300 ◽  
Author(s):  
J. Vallès ◽  
S. Fernández ◽  
E. Cortés ◽  
A. Morón ◽  
E. Fondevilla ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Defined Daily Dose ◽  
Treatment Methods ◽  
Daily Dose

scholarly journals Broad-Spectrum Antibiotic Regimen Affects Survival in Patients Receiving Nivolumab for Non-Small Cell Lung Cancer

2021 ◽  
Vol 14 (5) ◽  
pp. 445
Author(s):  
Min Jung Geum ◽  
Chungsoo Kim ◽  
Ji Eun Kang ◽  
Jae Hee Choi ◽  
Jae Song Kim ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Broad Spectrum ◽  
Small Cell ◽  
Defined Daily Dose ◽  
Small Cell Lung ◽  
Broad Spectrum Antibiotic ◽  
Negatively Associated ◽  
Daily Dose

Antibiotic-induced dysbiosis may affect the efficacy of immune checkpoint inhibitors. We investigated the impact of antibiotics on the clinical outcomes of nivolumab in patients with non-small cell lung cancer (NSCLC). Patients who received nivolumab for NSCLC between July 2015 and June 2018 and who were followed up until June 2020 were included in a retrospective cohort analysis. Of 140 eligible patients, 70 were on antibiotics. Overall survival (OS) was shorter in patients on antibiotics (ABX) compared to those not on antibiotics (NoABX) (p = 0.014). OS was negatively associated with piperacillin/tazobactam (PTZ) (HR = 3.31, 95% CI: 1.77–6.18), days of therapy (DOT) ≥ 2 weeks (HR = 2.56, 95% CI: 1.30–5.22) and DOT of PTZ. The defined daily dose (DDD) in PTZ (r = 0.27) and glycopeptides (r = 0.21) showed weak correlations with mortality. There was no difference in progression-free survival (PFS) between ABX and NoABX; however, PFS was negatively associated with the antibiotic class PTZ and DOT of PTZ. Therefore, the use of a broad-spectrum antibiotic, such as PTZ, the long-term use of antibiotics more than 2 weeks in total and the large amount of defined daily dose of specific antibiotics were associated with decreased survival in patients receiving nivolumab for NSCLC.

scholarly journals Implications of a defined daily dose fixed database for drug utilization research studies: The case of statins in Portugal

2021 ◽  
Author(s):  
Catarina Abrantes ◽  
Fernanda S. Tonin ◽  
Joana Reis‐Pardal ◽  
Margarida Castel‐Branco ◽  
Claudia Furtado ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Defined Daily Dose ◽  
Utilization Research ◽  
Daily Dose ◽  
Drug Utilization Research ◽  
Research Studies

scholarly journals National Antimicrobial Consumption: Analysis of Central Warehouses Supplies to In-Patient Care Health Facilities from 2017 to 2019 in Uganda

2021 ◽  
Vol 6 (2) ◽  
pp. 83
Author(s):  
Juliet Sanyu Namugambe ◽  
Alexandre Delamou ◽  
Francis Moses ◽  
Engy Ali ◽  
Veerle Hermans ◽  
...  
Keyword(s):  
Inpatient Care ◽  
Health Facilities ◽  
World Health ◽  
Defined Daily Dose ◽  
Antimicrobial Consumption ◽  
National Medical ◽  
The World ◽  
Daily Dose ◽  
Care Health ◽  
Health Organization

Antimicrobial consumption (AMC) surveillance at global and national levels is necessary to inform relevant interventions and policies. This study analyzed central warehouse antimicrobial supplies to health facilities providing inpatient care in Uganda. We collected data on antimicrobials supplied by National Medical Stores (NMS) and Joint Medical Stores (JMS) to 442 health facilities from 2017 to 2019. Data were analyzed using the World Health Organization methodology for AMC surveillance. Total quantity of antimicrobials in defined daily dose (DDD) were determined, classified into Access, Watch, Reserve (AWaRe) and AMC density was calculated. There was an increase in total DDDs distributed by NMS in 2019 by 4,166,572 DDD. In 2019, Amoxicillin (27%), Cotrimoxazole (20%), and Metronidazole (12%) were the most supplied antimicrobials by NMS while Doxycycline (10%), Amoxicillin (19%), and Metronidazole (10%) were the most supplied by JMS. The majority of antimicrobials supplied by NMS (81%) and JMS (66%) were from the Access category. Increasing antimicrobial consumption density (DDD per 100 patient days) was observed from national referral to lower-level health facilities. Except for NMS in 2019, total antimicrobials supplied by NMS and JMS remained the same from 2017 to 2019. This serves as a baseline for future assessments and monitoring of stewardship interventions.

42 THE DEFINED DAILY DOSE CAN ASSESS POSTOPERATIVE CHANGE IN ANTIHYPERTENSIVE DRUG CONSUMPTION IN PATIENTS WITH PRIMARY ALDOSTERONISM

2013 ◽  
Vol 189 (4S) ◽  
Author(s):  
Takanobu Utsumi ◽  
Mayuko Kaga ◽  
Tomokazu Sazuka ◽  
Mitsuru Yanagisawa ◽  
Kazuyoshi Nakamura ◽  
...  
Keyword(s):  
Antihypertensive Drug ◽  
Primary Aldosteronism ◽  
Drug Consumption ◽  
Defined Daily Dose ◽  
Postoperative Change ◽  
Daily Dose

scholarly journals Study on drug utilization pattern and cost analysis among the psychiatric patients treated with various benzodiazepine derivatives

2020 ◽  
Vol 9 (6) ◽  
pp. 975
Author(s):  
Dhivya Govindasamy ◽  
Gandhibabu Ramanathan ◽  
Talari Venkata Siva Prasad ◽  
Gopalakrishnan Ganesan
Keyword(s):  
Cost Analysis ◽  
Drug Utilization ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Psychiatric Patients ◽  
Age Groups ◽  
Alcohol Withdrawal Syndrome ◽  
Defined Daily Dose ◽  
Utilization Pattern ◽  
Daily Dose

Background: The objective of the study was to assess drug utilization pattern and cost analysis among the psychiatric patients treated with various benzodiazepine derivatives.Methods: This observational study was conducted in department of psychiatric, RMMCH, Annamalai University. The study period was 6 months (November 2018 to April 2019). A total of 50 psychiatric patients were included.Results: A total 50 patients among them 64% (32) males and 36% (18) female, were included in the study. Most of the patient were between the age groups of 18-29 years (30%). The most common clinical condition treated with benzodiazepines were alcohol dependence syndrome/alcohol withdrawal syndrome/ alcohol related psychotic disorder (34%). The majority of patients were prescribed with clonazepam (66.67%). The defined daily dose (DDD) per 100 bed days of benzodiazepines were found to be 0.89. In this study the comparison of cost analysis for the drug used and it was found that lorazepam (122%) are most expensive followed by chlordiazepoxide (93.3%) and clonazepam (78.57%). The cheapest drug was nitrazepam (36.84%).Conclusions: The majority of the patient admitted in the psychiatric department were suffering from Alcohol depending syndrome/alcohol withdrawal syndrome. The most commonly prescribed benzodiazepine was clonazepam followed by lorazepam and least prescribed diazepam and nitrazepam based on defined daily dose concept.

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 Defined Daily Dose and Appropriateness of Clinical Application: The Coxibs and Traditional Nonsteroidal Anti-Inflammatory Drugs for Postoperative Orthopaedics Pain Control in a Private Hospital in Malaysia

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 235
Author(s):  
Faizah Safina Bakrin ◽  
Mohd Makmor-Bakry ◽  
Wan Hazmy Che Hon ◽  
Shafeeq Mohd Faizal ◽  
Mohamed Mansor Manan ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Teaching Hospital ◽  
Pain Control ◽  
Orthopaedic Surgery ◽  
Prescribing Patterns ◽  
World Health ◽  
Defined Daily Dose ◽  
Daily Dose ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Introduction: Drug utilization of analgesics in a private healthcare setting is useful to examine their prescribing patterns, especially the newer injectable cyclooxygenase (COX)-2 inhibitors (coxibs). Objectives: To evaluate the utilization of coxibs and traditional nonsteroidal anti-inflammatory drugs (tNSAIDs) indicated for postoperative orthopaedic pain control using defined daily dose (DDD) and ratio of use density to use rate (UD/UR). Method: A retrospective drug utilization review (DUR) of nonsteroidal anti-inflammatory drugs (NSAIDs) at an inpatient department of a private teaching hospital in Seremban, Malaysia was conducted. Patients’ demographic characteristics, medications prescribed, clinical lab results, visual analogue scale (VAS) pain scores and length of hospital stay were documented. Orthopaedic surgeries, namely arthroscopy, reconstructive, and fracture fixation, were included. Stratified random sampling was used to select patients. Data were collected through patients’ medical records. The DDD per 100 admissions and the indicator UD/UR were calculated with the World Health Organization’s DDD as a benchmark. The inclusion criteria were patients undergoing orthopaedic surgery prescribed with coxibs (celecoxib capsules, etoricoxib tablets, parecoxib injections) and tNSAIDs (dexketoprofen injections, diclofenac sodium tablets). Data were analysed descriptively. This research was approved by the academic institution and the hospital research ethics committee. Result: A total of 195 records of patients who received NSAIDs were randomly selected among 1169 cases. In term of the types of orthopaedic surgery, the ratio of included records for arthroscopy:fracture fixation:reconstructive surgery was 55.4:35.9:8.7. Most of the inpatients had low rates of common comorbidities such as cardiovascular disease as supported by their baseline parameters. The majority were not prescribed with other concomitant prescriptions that could cause drug interaction (74.9%), or gastroprotective agents (77.4%). Overall, DDDs per 100 admissions for all NSAIDs were less than 100, except for parecoxib injections (389.23). The UD/UR for all NSAIDs were less than 100, except for etoricoxib tablets (105.75) and parecoxib injections (108.00). Discussion: As per guidelines, the majority (96.9%) received other analgesics to ensure a multimodal approach was carried out to control pain. From the UD/UR results, the arthroscopy surgery was probably the most appropriate in terms of NSAID utilization. Conclusion: The prescribing pattern of NSAIDs except parecoxib was appropriate based on adverse effect and concurrent medication profile. The findings of this DUR provide insight for a low-risk patient population at a private specialized teaching hospital on the recommended use of NSAIDs for postoperative orthopaedic pain control.

scholarly journals Prevalence of Antibiotics Prescription and Assessment of Prescribed Daily Dose in Outpatients from Mexico City

Antibiotics ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 38 ◽  
Author(s):  
Ramiro Sánchez-Huesca ◽  
Abel Lerma ◽  
Rebeca M.E Guzmán-Saldaña ◽  
Claudia Lerma
Keyword(s):  
Mexico City ◽  
Drug Dose ◽  
High Rate ◽  
World Health ◽  
Defined Daily Dose ◽  
Duration Of Treatment ◽  
Dose Frequency ◽  
Antibiotic Drug ◽  
Daily Dose ◽  
Health Organization

Pharmacoepidemiological research about antibiotics is supported by the World Health Organization (WHO), but data regarding antibiotic prevalence based on actual prescriptions and dosing patterns are insufficient. The aims were: (i) To estimate the prevalence and prescribed daily dose (PDD) of antibiotics in outpatients from Mexico City and (ii) to compare the PDD against the defined daily dose (DDD), as established by the WHO. The study included 685 prescriptions of antibiotics selected randomly from five geographical zones of Mexico City. Drug, dose, frequency, and duration of treatment were obtained from each prescription. PDD values of each antibiotic drug were calculated as the average of the daily doses. Sub-use and overuse were determined by the ratio PDD/DDD for each prescription. The most prescribed antibiotics to outpatients from Mexico City included six pharmacological groups: quinolones (28%), penicillins (23%), cephalosporins (17%), macrolides (10%), lincosamides (9%), and sulfonamides (4%). Both overuse and sub-use were high (55% and 63%, respectively). In conclusion, most of the antibiotics with a high prevalence of prescription also had a high rate of either sub-use or overuse, with prescribed doses that significantly differ with their corresponding DDD. The dosing variation has important clinical implications since it denotes low prescription control.

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