scholarly journals Increase and Change in the Pattern of Antibiotic Use in Serbia (2010–2019)

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 397
Author(s):  
Ana Tomas ◽  
Nebojša Pavlović ◽  
Nebojša Stilinović ◽  
Olga Horvat ◽  
Milica Paut-Kusturica ◽  
...  

The aim of this study was to determine and describe trends in antibiotics utilization in Serbia over a ten-year period. Data were retrieved from publicly available annual reports (2010–2019). The results were expressed as Defined Daily Dose (DDD) per 1000 inhabitants per day (DID). All calculations were performed using the DDD values for the 2020 Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) version for each year of the study, to account for the DDD changes during the study period. Antibiotics were classified using the WHO Access, Watch, Reserve (AWaRe) classification. Total utilization of antibacterials for systemic use increased from 17.25 DID in 2010 to 28.65 DID in 2019. A statistically significant increasing trend in the use of the Watch category antibiotics was observed. A tendency towards use of broad-spectrum antibiotics, apparent by a statistically significant increase in the rate of utilization of broad-spectrum macrolides, quinolones and third-generation cephalosporins vs. narrow-spectrum ones, as well as a significant increasing trend in the use of quinolones was identified. Total antibiotic utilization was found to be well above the European average. Several specific problem areas were identified, which requires further efforts to improve antibiotic prescribing. The present study provides the information needed to facilitate antibiotic stewardship in Serbia further and proposes specific interventions to optimize antibiotic use in Serbia.

Author(s):  
Sinta Rachmawati ◽  
Dewi Khurmi Masito ◽  
Ema Rachmawati

Infection is one of the health problems. It is mostly caused by bacteria. The increased incidence of bacterial infection results in higher antibiotic use. It can lead to antibiotic resistance risk. Antibiotic resistance may occur in pediatric patients. Morbidity, mortality, and high cost of medication are impact of this condition. Evaluation of antibiotic use needs to be done to ensure responsible use of antibiotics. ATCD/DDD (Anatomical Therapeutic Chemical/ Defined Daily Dose) method can be used to evaluate antibiotic use quantitatively. ATC classification is a system of grouping active substances according to their location of action and DDD is a measurement system that is connected to the ATC code.The purpose of this study was determining the profile of antibiotic use and measuring quantitative evaluation with ATC/DDD method in pediatric patients. The data was collected by observing the hospital medical record. The results of this study showed that cephalosporin (46,22%) was the most used group and cefotaxime (31,15%) was the most used type of antibiotic. While, the quantitative evaluation with ATC/DDD method indicated that the highest of antibiotic use was ceftriaxone (11,30 DDD/100 patient days) and the lowest was amikacin (0,03 DDD/100 patient days)


2016 ◽  
Vol 157 (46) ◽  
pp. 1839-1846 ◽  
Author(s):  
Ria Benkő ◽  
Mária Matuz ◽  
Edit Hajdú ◽  
Andrea Bor ◽  
Péter Doró ◽  
...  

Introduction: Growing bacterial resistance threatens public health, which can be tempered by prudent antibiotic use. Aim: To quantify systemic antibacterial use in Hungarian hospitals. Method: Consumption data were analysed using the Anatomical-Therapeutic-Chemical – Defined Daily Dose (ATC/DDD) methodology. Data were standardized for patient turnover and also for population to enable international benchmarking. Results: Hospital antibiotic use was quite constant (22.4 ± 1.5 DDD/100 patient-days), but its composition changed substantially. The use of parenteral products rose gradually (in 1996 26.4% and in 2015 41.6%). The pattern of use was homogenised due to the headway of co-amoxiclav use. A substantial increase of fluoroquinolone (2.3 vs. 4.2 DDD/100 patient-days) and third generation cephalosporin (1.0 vs. 2.9 DDD/100 patient-days) use was detected. In parallel the use of narrow spectra penicillins diminished. Conclusion: Hungarian hospital antibiotic use is low. The causes and the justification of this low use together with the internationally outstanding use of certain antibacterials should be addressed in future studies. Orv. Hetil., 2016, 157(46), 1839–1846.


2021 ◽  
Vol 3 (1) ◽  
pp. 26-34
Author(s):  
Fef Rukminingsih ◽  
Apriliyani Apriliyani

The high incidence of infectious diseases causes the use of antibiotics to increase. Inappropriate use of antibiotics will lead to resistance. Infectious diseases are included in the top 10 diseases in pediatric patients at St. Elisabeth Hospital.Semarang. This study aims to evaluate the use of antibiotics in pediatric patients in the Theresia ward of St. Elisabeth Hospital Semarang. This research is a descriptive observational study using retrospective data. Data were taken from medical records of pediatric patients in the Theresia ward at St. Elisabeth Hospital Semarang, aged 6 months - 14 years, the use of antibiotic therapy during the period October - December 2019. The data obtained were analyzed by calculating the quantity of antibiotic use using the Anatomical Therapeutic Chemical (ATC) and Defined Daily Dose (DDD)) / 100 patient-days methods. Based on the results of tracing medical record data, it was found that the number of pediatric patients in the Theresia room at St. Elisabeth Semarang for the period October - December 2019 is 385. The number of patients who received a single antibiotic was 162. The total value of DDD / 100 patient-days in the Theresia ward of St. Elisabeth Hospital Semarang for the period October - December 2019 is 18.17 with a total length of stay of 1117 days. The antibiotic with the highest DDD / 100 patient-days was ceftriaxone, namely 15.10. While the antibiotics that enter the DU 90% segment are ceftriaxone and cefotaxime.


2010 ◽  
Vol 11 (4) ◽  
pp. 124-126
Author(s):  
CE Curtis

Increasing rates of antibiotic resistance have been related to increased rates of antibiotic prescribing. This paper describes the use of indicators to measure and compare antibiotic use and enable hospitals to benchmark their practice. The Defined Daily Dose measure may be combined with a number of denominators that quantify patient activity in order to correct for workload variations between hospitals. This may be combined with data from mandatory surveillance schemes for various infections to inform prescribing practice.


2004 ◽  
Vol 15 (1) ◽  
pp. 29-35 ◽  
Author(s):  
James M Hutchinson ◽  
David M Patrick ◽  
Fawziah Marra ◽  
Helen Ng ◽  
William R Bowie ◽  
...  

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.


2019 ◽  
Vol 7 (2) ◽  
pp. 81-87
Author(s):  
Taradharani Wikantiananda ◽  
Adi Imam Tjahjadi ◽  
Reza Widianto Sudjud

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.


Author(s):  
LARASATI ARRUM KUSUMAWARDANI ◽  
ATIKA WAHYU PUSPITASARI ◽  
VANNISA NABILLA WIDYANTARI

Objective: The abnormally high use of antibiotics can indicate irrational prescribing. One of the ways by which to support rationally prescribingantibiotics is by evaluating their frequency of use. This study aimed to evaluate the use of antibiotics in 2018 by outpatients at the Kebayoran BaruPrimary Health Care of Indonesia.Methods: The study was a cross-sectional and descriptive design. Data were collected retrospectively from sampling outpatient records. The data wereon oral antibiotics prescribed in 2018 at Kebayoran Baru Primary Health Care. There were 10,553 prescriptions for oral antibiotics used as the studysamples. Both quantitative and qualitative evaluations were conducted. The quantitative evaluations were conducted using the method recommendedby the World Health Organization, namely, the anatomical therapeutic chemical/defined daily dose (DDD), and the qualitative evaluations wereconducted using the 90% drug utilization (DU 90%) method and the suitability of antibiotic use with the list of drugs in the Indonesian nationalformulary for the first-level health facilities (FKTP).Results: Three of the antibiotics used most often were amoxicillin at 0.9358 DDD/1000 inhabitants/d, ciprofloxacin at 0.4940 DDD/1000inhabitants/d, and cefadroxil at 0.1983 DDD/1000 inhabitants/d. The drugs within the DU 90% segment were amoxicillin, ciprofloxacin, cefadroxil,and thiamphenicol. There was 70% compatibility of antibiotic use with Indonesian national formulary for the FKTP.Conclusion: We suggest that the use of antibiotics at Kebayoran Baru Primary Health Care tended to be on the high side and not in accordance withnational guidelines.


Author(s):  
Sinta Rachmawati ◽  
Dewi Khurmi Masito ◽  
Ema Rachmawati

Infection is one of the health problems. It is mostly caused by bacteria. The increased incidence of bacterial infection results in higher antibiotic use. It can lead to antibiotic resistance risk. Antibiotic resistance may occur in pediatric patients. Morbidity, mortality, and high cost of medication are impact of this condition. Evaluation of antibiotic use needs to be done to ensure responsible use of antibiotics. ATCD/DDD (Anatomical Therapeutic Chemical/ Defined Daily Dose) method can be used to evaluate antibiotic use quantitatively. ATC classification is a system of grouping active substances according to their location of action and DDD is a measurement system that is connected to the ATC code.The purpose of this study was determining the profile of antibiotic use and measuring quantitative evaluation with ATC/DDD method in pediatric patients. The data was collected by observing the hospital medical record. The results of this study showed that cephalosporin (46,22%) was the most used group and cefotaxime (31,15%) was the most used type of antibiotic. While, the quantitative evaluation with ATC/DDD method indicated that the highest of antibiotic use was ceftriaxone (11,30 DDD/100 patient days) and the lowest was amikacin (0,03 DDD/100 patient days).


2021 ◽  
pp. 65-75
Author(s):  
Dirga Dirga ◽  
Sudewi Mukaromah Khairunnisa ◽  
Atika Dalili Akhmad ◽  
Irfanianta Arif Setyawan ◽  
Anton Pratama

The high prevalence of infectious disease in Indonesia causes increased use of antibiotics. It has serious consequences since it can cause germicidal resistance rapidly increased, significant morbidity and mortality, as well as high additional medical costs per year. This study aims to evaluate the appropriateness of antibiotic use inpatients in the internal medicine ward of Dr. H. Abdul Moeloek in Lampung Province. This research was observational (non-experimental) with a descriptive evaluative research design. The data were obtained from the retrospective tracing of medical records that collected by a purposive sampling technique on July-December 2017. A total of 163 inclusion samples are analyzed qualitatively and quantitatively. The qualitative analysis uses standard guidelines for the use of antibiotics and quantitative analysis uses the anatomical therapeutic chemical (ATC)/Defined Daily Dose (DDD) method. The results showed that out of 168 medical records, 19 types of antibiotics were used with a 118.57 DDD value of 100 patient days. The most widely prescribed was ceftriaxone (49.09%). The highest number of infections was diabetic ulcers with an incidence of 42 cases (25%). Out of 168 evaluated cases, 166 cases (98.8%) were appropriate indication, 168 cases (100%) were appropriate patients, 150 cases (89,29%) were appropriate medication, and 89 cases (52,97%) were appropriate dosage. These results indicated that the use of antibiotics inpatients in the internal medicine ward of Dr. H. Abdul Moeloek in Lampung Province were rational but it was necessary to consider selectivity regarding the choice of antibiotic use for infected patients.


2021 ◽  
Vol 14 (5) ◽  
pp. 445
Author(s):  
Min Jung Geum ◽  
Chungsoo Kim ◽  
Ji Eun Kang ◽  
Jae Hee Choi ◽  
Jae Song Kim ◽  
...  

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.


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