scholarly journals Radical cystectomy: Analysis of postoperative course

2010 ◽  
Vol 67 (8) ◽  
pp. 649-652
Author(s):  
Dimitrije Jeremic ◽  
Sasa Vojinov ◽  
Goran Marusic ◽  
Ivan Levakov ◽  
Srdjan Zivojinov
Keyword(s):  
Postoperative Complications ◽  
Radical Cystectomy ◽  
Anatomical Therapeutic Chemical ◽  
World Health ◽  
Defined Daily Dose ◽  
Postoperative Course ◽  
Clinical Center ◽  
Daily Dose ◽  
Blood Utilization ◽  
Health Organization

Background/Aim. Radical cystectomy is a method of choice in the therapy of infiltrative bladder cancer. The aim of this research was to analyze postoperative course after radical cystectomy (length of hospitalization, most frequent complications and utilization of antibiotics and transfusions). Methods. We analyzed the records of 82 patients operated on in the Department of Urology, Clinical Center of Vojvodina, in a three-year period. In order to aquire data World Health Organization (WHO) has developed Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology. Defined daily dose (DDD) is the assumed average maintenance dose per day for a drug use for its main indication. Results. Continent urinary derivation was preformed in 23.15% cases. Postoperative complications occurred in 18.29% of patients. Average blood utilization was 2.19 units. Blood utilization for continent derivations (n = 48) was 4.6 units, and incontinent ones 3.36 units. Totally 159.33 DDD/100 bed days were used. Conclusion. When preforming continent derivation there is a significant increase in blood utilization. Frequency of postoperative complications correlates to those reported in the literature.

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 Gambaran Penggunaan Antibiotik di Bangsal Penyakit Dalam RSUD Bangil Kabupaten Pasuruan

2020 ◽  
Vol 5 (1) ◽  
pp. 12
Author(s):  
Sinta Rachmawati ◽  
Rizki Laili Fazeri ◽  
Ika Norcahyanti
Keyword(s):  
World Health Organization ◽  
Anatomical Therapeutic Chemical ◽  
World Health ◽  
Defined Daily Dose ◽  
Daily Dose ◽  
Health Organization

<p>Penggunaan antibiotik yang tidak tepat akan berdampak terhadap terjadinya resistansi. Oleh karena itu, studi penggunaan antibiotik perlu dilakukan di fasilitas pelayanan kesehatan, termasuk rumah sakit. Penelitian ini bertujuan untuk mengetahui gambaran penggunaan antibiotik di bangsal penyakit dalam Rumah Sakit Umum Daerah (RSUD) Bangil Kabupaten Pasuruan dengan menggunakan metode<em> Anatomical Therapeutic Chemical</em> (ATC)/<em>Defined Daily Dose</em> (DDD). ATC/DDD adalah metode perhitungan penggunaan antibiotik secara kuantitatif yang direkomendasikan oleh <em>World Health Organization</em> (WHO). Pengambilan data dilakukan secara retrospektif menggunakan sumber data excel berupa rekapitulasi rekam medik. Populasi pada penelitian ini adalah seluruh pasien rawat inap dewasa di bangsal penyakit dalam sepanjang tahun 2017. Sejumlah 973 data dari keseluruhan populasi memenuhi kriteria inklusi. Analisis data dilakukan berdasarkan pada karakteristik pasien, profil antibiotik dan perhitungan kuantitatif dengan metode ATC/DDD. Hasil penelitian menunjukkan bahwa golongan antibiotik yang paling banyak digunakan adalah golongan sefalosporin sebesar 51,41%, sedangkan jenis antibiotik yang paling banyak diresepkan yaitu ceftriaxone dengan jumlah sebesar 25,86%. DDD/100 <em>patient-days</em> tertingi adalah ceftriaxone dengan nilai 27,79 DDD/100 <em>patient-days</em>. Perlu dilakukan penelitian lanjutan dengan menggunakan metode Gyssens untuk mengetahui rasionalitas penggunaan antibiotik.</p>

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.

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.

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 Evaluation of Antibiotic Use in Kazakhstan for the Period 2017–2019 Based on WHO Access, Watch and Reserve Classification (AWaRe 2019)

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 58
Author(s):  
Gulzira Zhussupova ◽  
Dinara Utepova ◽  
Galiya Orazova ◽  
Saule Zhaldybayeva ◽  
Galina Skvirskaya ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
World Health Organization ◽  
Antibiotic Use ◽  
The State ◽  
World Health ◽  
Defined Daily Dose ◽  
Upward Trend ◽  
The World ◽  
Daily Dose ◽  
Health Organization

The purpose of this study is to conduct a comparative analysis of the consumption of antibiotics for systemic use reimbursed by the state in Kazakhstan for 2017–2019 with the Access, Watch, and Reserve classification (AWaRe 2019) of the World Health Organization (WHO). The evaluation of the consumption of antibiotics for systemic use in Kazakhstan for 2017–2019 was carried out using the ATC/DDD methodology in accordance with the WHO AWaRe classification. The study used data on all antibiotics that were centrally purchased by a single purchaser during the study period. To understand how often Access group antibiotics are taken in Kazakhstan, the top-10 most consumed antibiotics were additionally studied. The results of a comparative analysis of the antibiotics for systemic use consumption for 2017–2019 by the Access, Watch, and Reserve groups showed a negative trend of a decrease in the consumption of Access group drugs from 1.17 defined daily dose (DDDs) per 1000 inhabitants per day (DID) (39%) in 2017 to 0.59 DID (30%) in 2019. There is an increase in consumption of Watch group antibiotics from 1.84 DID (61%) in 2017 to 1.37 DID (68%) in 2019, as well as an increase in consumption of Reserve antibiotics from 0.001 DID (0.03%) to 0.4 DID (2.11%). In recent years in Kazakhstan, there has been a decrease in the consumption of Access group antibiotics. In addition, the Watch group antibiotics are widely consumed with a certain upward trend. In 2019, one Reserve antibiotic was included in the top-10 most commonly consumed antibiotics. There is a predominant consumption of parenteral forms of antibiotics for systemic use in the country.

scholarly journals Assigning Defined Daily/Course Doses for Antimicrobials in Turkeys to Enable a Cross-Country Quantification and Comparison of Antimicrobial Use

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 971
Author(s):  
Philip Joosten ◽  
Steven Sarrazin ◽  
Claire Chauvin ◽  
Gabriel Moyano ◽  
Katharina Wadepohl ◽  
...  
Keyword(s):  
Standard Dose ◽  
World Health ◽  
Production Cycle ◽  
Antimicrobial Use ◽  
Defined Daily Dose ◽  
Daily Dose ◽  
Cross Country ◽  
Health Organization ◽  
Antimicrobial Treatments ◽  
Huge Variation

Antimicrobial resistance (AMR) threatens our public health and is mainly driven by antimicrobial usage (AMU). For this reason the World Health Organization calls for detailed monitoring of AMU over all animal sectors involved. Therefore, we aimed to quantify AMU on turkey farms. First, turkey-specific Defined Daily Dose (DDDturkey) was determined. These were compared to the broiler alternative from the European Surveillance of Veterinary Antimicrobial Consumption (DDDvet), that mention DDDvet as a proxy for other poultry species. DDDturkey ranged from being 81.5% smaller to 48.5% larger compared to its DDDvet alternative for broilers. Second, antimicrobial treatments were registered on 60 turkey farms divided over France, Germany and Spain between 2014 and 2016 (20 flocks per country). Afterwards, AMU was quantified using treatment incidence (TI) per 100 days. TI expresses the percentage of the rearing period that the turkeys were treated with a standard dose of antimicrobials. Minimum, median and maximum TI at flock level and based on DDDturkey = 0.0, 10.0 and 65.7, respectively. Yet, a huge variation in amounts of antimicrobials used at flock level was observed, both within and between countries. Seven farms (12%) did not use any antimicrobials. Aminopenicillins, polymyxins, and fluoroquinolones were responsible for 72.2% of total AMU. The proportion of treating farms peaked on week five of the production cycle (41.7%), and 79.4% of the total AMU was administered in the first half of production. To conclude, not all DDDvet values for broilers can be applied to turkeys. Additionally, the results of AMU show potential for reducing and improving AMU on turkey farms, especially concerning the usage of critically important antimicrobials.

scholarly journals The Relevance of Defined Daily Dose concept in Drug Utilisation Research: A Review

2021 ◽  
Vol 11 (4-S) ◽  
pp. 162-165
Author(s):  
Agnus Baiju ◽  
Rosmin Jacob ◽  
K. Krishnakumar
Keyword(s):  
Drug Utilisation ◽  
Anatomical Therapeutic Chemical ◽  
Cost Effective ◽  
World Health Organisation ◽  
Economic Consequences ◽  
World Health ◽  
Special Focus ◽  
Defined Daily Dose ◽  
Rational Drug ◽  
Daily Dose

According to World Health Organisation (WHO), drug utilisation is defined as the marketing, distribution, prescription and the use of drugs in society with special focus on resulting medical, social and economic consequences and it has turned into a powerful scientific tool for ensuring the rational and cost-effective use of drugs. A standard method is required to identify and aggregate drug data. This manuscript provides an overview of the WHO Anatomical Therapeutic Chemical (ATC) classification and the associated measure, Defined Daily Dose (DDD), as a methodology for evaluating drug utilisation. Keywords: Drug utilisation research, Anatomical Therapeutic Chemical classification system, Defined Daily Dose, Rational drug use.

The Use of the World Health Organisation Anatomical Therapeutic Chemical/Defined Daily Dose Methodology in Canada

2004 ◽  
Vol 38 (1) ◽  
pp. 15-27 ◽  
Author(s):  
Ingrid S. Sketris ◽  
Colleen J. Metge ◽  
Jennifer L. Ross ◽  
Mary E. MacCara ◽  
Danna G. Comeau ◽  
...  
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
World Health Organisation ◽  
World Health ◽  
Defined Daily Dose ◽  
The World ◽  
Daily Dose

scholarly journals Measuring Medicine Use: Applying ATC/DDD Methodology to Real-World Data

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 60
Author(s):  
Samantha Hollingworth ◽  
Therése Kairuz
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
World Health ◽  
Defined Daily Dose ◽  
Health Coverage ◽  
Medicine Use ◽  
Real World Data ◽  
Middle Income ◽  
Middle Income Countries ◽  
Drug Utilization Studies ◽  
Health Organization

Medicines are essential for the treatment of acute, communicable, and non-communicable diseases. The World Health Organization developed a toolkit for drug (medicine) utilization studies to assist in reviewing and evaluating the prescribing, dispensing, and use of medicines. There is a growing need for rigorous studies of medicine use in low- and middle-income countries (LMIC) using standard approaches, especially in the context of universal health coverage. This commentary provides a succinct summary of how to use the WHO anatomical therapeutic chemical (ATC)/defined daily dose (DDD) methodology in pharmacoepidemiological studies, with a focus on LMIC contexts. We drew on information from WHO resources and published literature, citing examples and case studies. We encourage readers to publish their drug utilization studies, although we caution about predatory journals. We recommend the use of the RECORD-PE initiative which focuses on methods for doing pharmacoepidemiological research and evaluating the quality of published papers.

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