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.

Evaluation of ambulatory antibiotic use in Hungary using drug-specific quality indicators

2013 ◽  
Vol 154 (24) ◽  
pp. 947-956 ◽  
Author(s):  
Mária Matuz ◽  
Ria Benkő ◽  
Edit Hajdú ◽  
Réka Viola ◽  
Gyöngyvér Soós
Keyword(s):  
Quality Indicators ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Consumption Patterns ◽  
Defined Daily Dose ◽  
Beta Lactams ◽  
Daily Dose ◽  
Constant Quantity ◽  
Rational Use Of Antibiotics

Introduction: Rational use of antibiotics is an important tool in combating antibiotic resistance. Aim: The aim of the authors was to evaluate the quality of ambulatory antibiotic use in Hungary. Method: Crude antibiotic sales data for the period between 1996 and 2010 were converted into DDD (Defined Daily Dose) per 1000 inhabitants and per year. The recently developed and validated drug-specific quality indicators were used to evaluate antibiotic use. Results: Beside constant quantity (18.0±1.8 DDD/1000 inhabitants/day), the authors detected major changes in the composition of antibiotic use. Ratios of the consumption of broad to narrow spectrum beta-lactams and macrolides increased eight-fold (1996: 2.2 vs. 2010: 15.8) and consumption of fluoroquinolones tripled. Out of the ten surveyed drug-specific quality indicators, Hungary belonged to the European elite in case of three, while considering the remaining seven, Hungary ranked among the weak or weakest European countries. Conclusion: In quantity Hungary an ambulatory antibiotic use resembles to Scandinavian countries while it mimics antibiotic consumption patterns of southern countries. Orv. Hetil., 2013, 154, 947–956.

scholarly journals The Evaluation of Antibiotic Consumption at the Inpatient Level in Kazakhstan from 2011 to 2018

Antibiotics ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 57 ◽  
Author(s):  
Gulzira Zhussupova ◽  
Galina Skvirskaya ◽  
Vladimir Reshetnikov ◽  
Viktorija Dragojevic-Simic ◽  
Nemanja Rancic ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Anatomical Therapeutic Chemical ◽  
Antibiotic Use ◽  
Generation Cephalosporin ◽  
Antibiotic Consumption ◽  
Essential Medicines ◽  
World Health ◽  
Defined Daily Dose ◽  
Total Consumption ◽  
Systemic Action

Antimicrobial agents have a rather special position due to their importance as essential medicines for the treatment of infectious diseases. Evidence-based prescriptions are needed to optimize the use of antimicrobials in humans, as well as to decrease antimicrobial resistance. The aim of this study was to assess the inpatient consumption of antimicrobial drugs for systemic use in the period 2011–2018 in Kazakhstan. This article presents the results of an evaluation of the inpatient use of antibacterial drugs for systemic use (group J01) for the period 2011–2018 using the anatomical therapeutic chemical (ATC) classification)/defined daily dose (DDD) methodology recommended by the World Health Organization. Inpatient antimicrobial utilization is expressed as DDDs/1000 inhabitants/day (DID). The results of the assessment for inpatient antibiotic use (over an eight-year period) showed a decrease in the total consumption of antibiotics for systemic action in Kazakhstan (2011: 12.72 DID; 2018: 2.74 DID). Among oral formulations, levofloxacin was consumed the most, and cefazolin was consumed the most among the parenteral formulations of antimicrobials. The three drugs consumed the most included cefazolin (first-generation cephalosporin), ceftriaxone (third-generation cephalosporin), and cefuroxime (second-generation cephalosporin). The total consumption of antibacterials for systemic action in Kazakhstan decreased during the analyzed period, but there was an irrational use of certain groups of drugs.

scholarly journals Measurement of Antibiotic Consumption: A Practical Guide to the Use of the Anatomical Therapeutic Chemical Classification and Defined Daily Dose System Methodology in Canada

2004 ◽  
Vol 15 (1) ◽  
pp. 29-35 ◽  
Author(s):  
James M Hutchinson ◽  
David M Patrick ◽  
Fawziah Marra ◽  
Helen Ng ◽  
William R Bowie ◽  
...  
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Defined Daily Dose ◽  
Global Public Health ◽  
Anatomical Therapeutic Chemical Classification ◽  
Public Health Importance ◽  
Chemical Classification ◽  
Daily Dose ◽  
Relationship Of

Despite the global public health importance of resistance of microorganisms to the effects of antibiotics, and the direct relationship of consumption to resistance, little information is available concerning levels of consumption in Canadian hospitals and out-patient settings. The present paper provides practical advice on the use of administrative pharmacy data to address this need. Focus is made on the use of the Anatomical Therapeutic Chemical classification and Defined Daily Dose system. Examples of consumption data from Canadian community and hospital settings, with comparisons to international data, are used to incite interest and to propose uses of this information. It is hoped that all persons responsible for policy decisions regarding licensing, reimbursement, prescribing guidelines, formulary controls or any other structure pertaining to antimicrobial use become conversant with the concepts of population antibiotic consumption and that this paper provides them with the impetus and direction to begin accurately measuring and comparing antibiotic use in their jurisdictions.

scholarly journals Antibiotic Utilization Pattern in the Intensive Care Unit of Tertiary Hospital in West Java, Indonesia

2019 ◽  
Vol 7 (2) ◽  
pp. 81-87
Author(s):  
Taradharani Wikantiananda ◽  
Adi Imam Tjahjadi ◽  
Reza Widianto Sudjud
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Anatomical Therapeutic Chemical ◽  
Antibiotic Use ◽  
Tertiary Hospital ◽  
Defined Daily Dose ◽  
Antibiotic Utilization ◽  
Daily Dose ◽  
Bed Days ◽  
International Measurement

Objective: To find out the pattern of antibiotic utilization in intensive care unit (ICU). The high use of antibiotics in intensive care may increase antibiotic resistance. Methods: This was a retrospective study with total sampling method from patients who were treated in ICU in the period of January to June 2016. Selected data is processed using the Anatomical Therapeutic Chemical (ATC) Classification/Defined Daily Dose (DDD) system as an international measurement standard for analyzing and comparing usage applied by the WHO. Results: The results showed that of the 57 medical records collected, the total antibiotic use was 295.72 DDD/100 bed-days. Levofloxacin, meropenem, ceftriaxone, ceftazidime, and metronidazole were the five maximally utilized antibiotics with 143.18, 49.88, 30.62, 19.74, dan 16.99 DDD/100 bed-days respectively. Conclusion: The most frequently used of antibiotics is ceftriaxone, used in 54.39% of patients. Whereas in number, the most widely used antibiotic is levofloxacin with a total of 143.18 DDD/100 bed-days.

scholarly journals Trends and Pattern of Antibiotic Use in Children in Northern Spain. Lessons From Interpreting Data About Antimicrobial Consumption in Outpatients

2021 ◽  
Author(s):  
Laura Calle-Miguel ◽  
Carlos Pérez Méndez ◽  
Elisa García García ◽  
Belén Moreno Pavón ◽  
Gonzalo Solís-Sánchez
Keyword(s):  
General Population ◽  
Pediatric Population ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Defined Daily Dose ◽  
Northern Spain ◽  
Consumption Behavior ◽  
Daily Dose ◽  
Pediatric Outpatients

Abstract Monitoring of antibiotic prescription and consumption behavior is crucial. The Access, Watch and Reserve (AWaRe) classification of antibiotics has been recently introduced in order to measure and improve patterns of antibiotic use. In this study, retrospective data about systemic antibiotic consumption (expressed in defined daily dose per 1000 inhabitants per day [DID]) in pediatric outpatients in a region in Northern Spain (around 100000 children up to 14 years old) from 2005 to 2018 were analysed and compared with antibiotic consumption in general population in Spain. The pattern of use was analysed by the percentage of the current AWaRe categories, the Access-to-Watch index and the amoxicillin index. Data were calculated annually and compared into two periods. Mean antibiotic consumption in pediatric outpatients was 14.0 DID (CI 95% 13.38–14.62). It remained stable throughout the study and was lower than consumption in general population in Spain, particularly from 2016. Changes in the consumption of the main active principles have led to an improvement in the three metrics of the pattern of use. It is important to have a thorough knowledge of the methodology applied in studies about antibiotic consumption. There is a lack of an optimal standardized metric for pediatric population.

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.

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.

In reply to: “Antimicrobial defined daily dose adjusted by weight: A proposal for antibiotic consumption measurement in children”

2019 ◽  
Vol 37 (5) ◽  
pp. 357-358
Author(s):  
Walter-Alfredo Goycochea-Valdivia ◽  
Elena Montecatine-Alonso ◽  
María-Victoria Gil-Navarro ◽  
Olaf Neth
Keyword(s):  
Antibiotic Consumption ◽  
Defined Daily Dose ◽  
Daily Dose

scholarly journals Lessons Learned from Implementing Clostridium difficile-Focused Antibiotic Stewardship Interventions

2014 ◽  
Vol 35 (S3) ◽  
pp. S86-S95
Author(s):  
B. Ostrowsky ◽  
R. Ruiz ◽  
S. Brown ◽  
P. Chung ◽  
E. Koppelman ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Intervention Group ◽  
Antibiotic Consumption ◽  
Lessons Learned ◽  
Audit And Feedback ◽  
Defined Daily Dose ◽  
Case Control Studies ◽  
Days Of Therapy ◽  
Daily Dose ◽  
Over Time

Objective.To determine whether controlling the prescription of targeted antibiotics would translate to a measurable reduction in hospital-onset Clostridium difficile infection (CDI) rates.Design.A multicenter before-and-after intervention comparative study.Setting/Participants.Ten medical centers in the greater New York region. Intervention group comprised of 6 facilities with early antimicrobial stewardship programs (ASPs). The 4 facilities without ASPs made up the nonintervention group.Interventions/Methods.Intervention facilities identified target antibiotics using case-control studies and implemented ASP-based strategies to control their use. Pre- and postintervention hospital-onset CDI rates and antibiotic consumption were compared for a 20-month period from June 2010 to January 2012. Antibiotic usage was compared using defined daily dose, days of therapy, and number of courses prescribed. Comparisons used bivariate and regression techniques.Results.Intervention facilities identified piperacillin/tazobactam, fluoroquinolones, or cefepime (odds ratio, 2.0-9.8 in CDI case patients compared with those without CDI) as intervention targets and selected several interventions (all included a component of audit and feedback). Varying degrees of success were observed in reducing antibiotic consumption over time. Total target antibiotic use significantly decreased (P < .05) when measured by days of therapy and number of courses but not by defined daily dose. Intravenous moxifloxacin and oral ciprofloxacin use showed significant reduction when measured by defined daily dose and days of therapy (P ≤ .01). Number of courses with all forms of these antibiotics was reduced (P ≤ .005). Intervention hospitals reported fewer hospital-onset CDI cases (2.8 rate point difference) compared with nonintervention hospitals; however, we were unable to show statistically significant decreases in aggregate hospital-onset CDI either between intervention and nonintervention groups or within the intervention group over time.Conclusions.Although decreases in target antibiotic consumption did not translate into reductions of hospital-onset CDI in this study, many valuable lessons (including implementation strategies and antibiotic consumption measures) were learned. The findings can inform potential policy decisions regarding incorporating control of CDI and ASP as healthcare quality measures.

scholarly journals IMPACT OF ANTIMICROBIAL STEWARDSHIP PROGRAM ON THE USE OF ANTIBIOTICS IN PNEUMONIA PATIENTS AT TEACHING HOSPITAL IN SURAKARTA INDONESIA

2021 ◽  
pp. 20-23
Author(s):  
HIDAYAH KARUNIAWATI ◽  
TRI YULIANTI ◽  
DEWI KUROTA AINI ◽  
FINISHIA ISNA NURWIENDA
Keyword(s):  
Antimicrobial Stewardship ◽  
Antibiotic Use ◽  
Study Data ◽  
Defined Daily Dose ◽  
Inappropriate Use ◽  
Stewardship Program ◽  
Daily Dose ◽  
The Impact ◽  
Method Show

Objective: Antibiotic resistance is a serious problem worldwide. One cause of antibacterial resistance is the inappropriate use of antibiotics. Thestudy of antibiotic use in hospitals found that 30–80% were not based on indications. Antimicrobial Stewardship Programs (ASP) was developed tocontrol antimicrobial resistance. This study aims to evaluate the impact of ASP in pneumonia patients qualitatively and quantitatively pre-post ASPapplied.Methods: This research is a non-experimental study. Data were taken from the medical records of pneumonia patients and analyzed qualitativelyusing the Gyssens method and quantitatively using the Defined Daily Dose (DDD) method. Sampling was conducted through purposive sampling andresults were described descriptively.Results: During the study period, 96 samples were obtained with 48 data pre-ASP and 48 data post-ASP. The results of the qualitative analysis usingthe Gyssens method show an increase in the prudent use of antibiotics from 31.25% to 62.5% pre-post ASP, respectively. Quantitative evaluationshows a decrease of antibiotic use pre-post ASP from 90.84 DDD/100 patients-days to 61.42 DDD/100 patients-days.Conclusion: The ASP can improve the quality of antibiotic use in pneumonia patients quantitatively and qualitatively.

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