scholarly journals Quality Appraisal of Ambulatory Oral Cephalosporin and Fluoroquinolone Use in the 16 German Federal States from 2014–2019

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 831
Author(s):  
Gabriele Gradl ◽  
Johanna Werning ◽  
Salka Enners ◽  
Marita Kieble ◽  
Martin Schulz
Keyword(s):  
Bacterial Resistance ◽  
Antibiotic Use ◽  
Oral Cephalosporin ◽  
Federal States ◽  
Defined Daily Doses ◽  
German Federal States ◽  
City States ◽  
The City ◽  
Dispensing Data

Background: Despite concerns about causing bacterial resistance and serious side effects, oral cephalosporins and fluoroquinolones are still frequently prescribed in Germany. We aimed to test a method for the detection of regional quality differences in the use of oral cephalosporins and fluoroquinolones and to apply this to the German federal states. Methods: Use of antibiotics from 2014–2019 was analyzed using dispensing data from community pharmacies claimed to the statutory health insurance (SHI) funds. Quality of regional antibiotic use in 2019 was assessed by calculating indicators based on defined daily doses per 1000 SHI-insured persons per day (DID). Oral cephalosporin and fluoroquinolone use was followed by linear regression analyses. Results: The method used was suitable to find meaningful quality differences in ambulatory oral cephalosporin and fluoroquinolone use between the German federal states. In 2019, DID varied from 1.62 in Brandenburg to 3.17 in Rhineland-Palatinate for cephalosporins and from 0.47 in Brandenburg to 0.89 in Saarland for fluoroquinolones. The city-states Hamburg, Bremen, and Berlin showed highest quality with the applied indicator set. From 2014–2019, a significant decrease in utilization of oral cephalosporins was found in all federal states. During 2017–2019, all states showed a significant decline of fluoroquinolone use.

scholarly journals Correlation between antibiotic consumption and bacterial resistance as quality indicator of proper use of these drugs in inpatients

2009 ◽  
Vol 66 (4) ◽  
pp. 307-312 ◽  
Author(s):  
Radmila Velickovic-Radovanovic ◽  
Jasmina Petrovic ◽  
Branislava Kocic ◽  
Snezana Antic ◽  
Gordana Randjelovic
Keyword(s):  
Bacterial Resistance ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
E Coli ◽  
Defined Daily Doses ◽  
Clinical Center ◽  
Rational Drug ◽  
Antibiotics Use ◽  
Amoxicillin Clavulanic Acid ◽  
Investigation Period

Background/Aim. Antibiotics are the most frequently used medications in Serbian hospitalized patients. Information about antibiotic utilization and sensitivity among inpatients in Serbia is scanty, and there are no available publications on the topic. The aim of this study was to investigate the correlation between antibiotic use and bacterial resistance in the Clinical Center Nis, one of the biggest hospitals in Serbia. Methods. The data on antibiotics use in inpatients were obtained from the database of the Department of Pharmacotherapy and expressed as defined daily doses per 100 bed-days (DBD), during 2003-2007. Bacterial resistances were given as percentages of resistant isolates. Results. During the investigation period, the overall consumption of antibiotics had a significant decrease in 2007, by 22.99% (62.23 : 47.92 DBD; p < 0.05). The most frequently used antibiotics were cephalosporins, followed by penicillin's, aminoglycosides and quinolones. Hospital aminoglycosides consumption was reduced in 2007 to 59.9% (13.4 : 5.53 DBD) while the resistance to amikacin was reduced from 40.88% to 32.1%. However, utilization of ciprofloxacin had a significant increase in 2007 (120.7%). There was an alarming increase in the level of resistance to ciprofloxacin in our hospital (from 13.5% to 28.3 % in Escherichia coli and from 11.1 to 30.09% in Proteus mirabilis). Reduction of E coli resistant to amoxicillin+clavulanic acid correlated significantly with their utilization, while the resistance for all isolates decreased from 52.16% to 24.40%. Conclusions. These results confirm an association between the use of antibiotics and the prevalence of resistance. This methodology could provide good quality indicators of rational drug use and serve for local monitoring of antibiotics use and resistance, as well as for external comparison.

scholarly journals Analysis of Quality of Antibiotic Usage on Patient with Internal and Surgical Service

2021 ◽  
Vol 57 (1) ◽  
pp. 1
Author(s):  
Nurul Ma'rifah ◽  
Didik Hasmono ◽  
Usman Hadi ◽  
Kuntaman Kuntaman
Keyword(s):  
Internal Medicine ◽  
Analytical Study ◽  
Bacterial Resistance ◽  
Antibiotic Use ◽  
Developed Countries ◽  
Surgical Patients ◽  
Appropriate Use ◽  
Cross Sectional ◽  
Inappropriate Use

It is well-known that hospitals are health facility with the widely use of antibiotics. It is about 13-37% from the total hospitalized patients in developed countries use antibiotic, even in developing countries can reach 30-80%. There is identified correlation between antibiotic use and the development of bacterial resistance. Even though the resistance cannot be eliminated, but its development can be suppressed  by the increasing of prudent use of antibiotics. The aim of this study was to determine the quality of antibiotic use on internal medicine and surgical patients in Aisiyah Hospital Bojonegoro. The study was a prospective cross sectional observational analytical study of among patients of internal and surgical who received antibiotic therapy in the period of August - September 2017. The total 50 samples were collected in this study which consists of 33 internal medicine  and 17 surgical patients. From 50 samples, there were 16 types of antibiotics with the total use of 81 of antibiotic use. As the result, in internal medicine patients there were 22 (40%) of appropriate use of antibiotics, 4 (7.27%) of inappropriate use and 29 (52.73%) use of antibiotics without indication. In surgical patients, there were 12 (46.15%) of appropriate use of antibiotics, 2 (7.69%) of inappropriate use and 12 (46.15%) use of antibiotics without indication. This study showed that more than 50% of antibiotic use were inappropriate, and mainly antibiotic with no indication, among patients hospitalized in Aisyiyah Hospital Bojonegoro.

Gestaltungsmöglichkeiten der Stadtstaaten bei gegebener Steuersatzautonomie für die Körperschaftsteuer

2008 ◽  
Vol 59 (1) ◽  
Author(s):  
Michael Broer
Keyword(s):  
Tax Revenue ◽  
Tax Base ◽  
Tax Rate ◽  
Corporation Tax ◽  
Federal States ◽  
Local Business ◽  
Business Tax ◽  
City States ◽  
Statutory Tax Rate ◽  
The City

SummaryGerman corporate companies are taxed with a federal corporation tax and with a local business tax. The latter has a similar, but broader tax base (including e. g. 25 % of interest payments) and its tax rate is set independently by every municipality including the so called city-states (Stadtstaaten). The federal corporation tax revenue is equally split between the federal government and the federal states (Länder). Till now the federal tax rate has been fixed by the German government. Federal states have not had the right to rule the tax rate of their share of corporation tax. At present a federal commission is discussing whether this should be possible in the future. Once granted this privilege, the city-states will be able to substitute their part of corporation tax by a higher local business tax. Furthermore, because of its broader tax base, there will be a reduction of the statutory tax rate for corporations without a decrease in tax revenue. This paper analyses the revenue effects of this substitution for the city-states taking into account the German fiscal equalization system and the incentive of profit shifting to the city-states. The analysis shows some positive revenue effects to the city-states, if they will substitute their part of corporation tax by a higher local business tax. The revenue effects are subject to different scenarios and add up to 17.5 million for Hamburg, 10.4 million for Berlin and 3.6 million for Bremen.

scholarly journals A Retrospective Surveillance of the Antibiotics Prophylactic Use of Surgical Procedures in Private Hospitals in Indonesia

2018 ◽  
Vol 54 (5) ◽  
pp. 323-329 ◽  
Author(s):  
Fauna Herawati ◽  
Rika Yulia ◽  
Eelko Hak ◽  
Adriaan H. Hartono ◽  
Timo Michiels ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Bacterial Resistance ◽  
Elective Surgery ◽  
Daily Practice ◽  
Antibiotic Use ◽  
Private Hospitals ◽  
Defined Daily Doses ◽  
Hospitalization Costs ◽  
Precision Therapy ◽  
Prophylactic Use

Background: According to international guidelines, prophylactic antibiotics in elective surgery should be given as a single dose 30 to 60 minutes before the operation is conducted. Postoperative administration of antibiotics should be discontinued 24 hours after surgery to minimize bacterial resistance and to keep control over hospitalization costs. There is a lack of data on the actual antibiotic use around surgical procedures in Indonesia. Objective: This retrospective surveillance study aimed to obtain defined daily doses (DDD) and DDDs per 100 bed days (DDD-100BD) for prophylactically used antibiotics in two private hospitals in Surabaya, East Java. These hospitals are considered to be representative for the current situation in Indonesia. Method: Data from a total of 693 patients over a nearly 1-year period (2016) were collected and evaluated. Results: The overall DDD per patient was 1.5 for hospital A and 1.7 for hospital B. The overall DDD-100BD was 30 for hospital B. Of the 24 antibiotics given prophylactically, ceftriaxone was the most commonly used in both hospitals. Conclusion: There was a clear discrepancy between daily practice in both hospitals and the recommendations in the guidelines. This study shows that better adherence to antibiotic stewardship is needed in Indonesia. Substantial improvements need to be made toward guided precision therapy regarding quantity (dose and frequency), route of administration (prolonged intravenous), and choice of the type of antibiotic.

Model Pemberdayaan Usaha Mikro Dan Pengaruhnya Terhadap Kemandirian Usaha

2015 ◽  
Vol 2 (1) ◽  
pp. 75-93
Author(s):  
Mudasetia Hamid ◽  
Evy Rosalina Widyayanti
Keyword(s):  
Human Resources ◽  
Small And Medium Enterprises ◽  
Poverty Rate ◽  
Cultural Centers ◽  
Central Java ◽  
Tourism Education ◽  
The Indian Ocean ◽  
Medium Enterprises ◽  
The City

Yogyakarta is a city and the capital of Yogyakarta Special Region in Java, Indonesia. It is renowned as a center of tourism, education and culture. Yogyakarta is one of the foremost cultural centers of Java. This region is located at the foot of the active merapi vulcano. Yogyakarta is often called the main gateway to the Central Java as where it is geographically located. It stretches from Mount Merapi to the Indian Ocean. This province is one of the most densely populated areas of Indonesia. Yogyakarta is popular tourist destination in indonesia after Bali. These have attracted large number of visitors from across Indonesia and abroad to the city. This status makes Yogyakarta is one of the most heterogeneus cities in Indonesia. In edition, Yogyakarta has attracted large number of people to reside in this city for business. One of these comers is small entrepreneurs with their market munchies enterprise (specially a traditional snack trader). This business is one of famous business in Yogyakarta, we will find rows of pavement vendors selling market munchies. The students and tourists are their main target customers. Market munchies enterprise is part of small and medium enterprises SMEs as livelihood activities. SMEs has an important role in economic growth of Indonesia. Therefore, it is very important to develop and strengthen the micro enterprise empowerment. Micro enterprise empowerment is one of strategy to reduce the poverty rate in Indonesia. Major challenger in implement this program are that micro entrepreneurs are conventional and have satisfied with their revenue. It is very important to develop a comprehensive and sustainable micro enterprise empowerment which consist of strengthen the quality of human resources, maximize the government’s roles, empower the enterprise capital and strengthen the partnership and autonomous. Micro enterprise autonomy will contribute to the economic and investment climate. This will lead to establish an accountable enterprise both for the micro enterprise and customers which at the end will strengthen the development of the micro enterprise in Yogyakarta.Keyword: micro entreprise, human resources, government roles, capital, partnership and autonomous.

Mites of the family Phytoseiidae (Parasitiformes, Mesostigmata) at the plants in Brovary town

2014 ◽  
Vol 25 (3-4) ◽  
pp. 77-83
Author(s):  
S. L. Grabovska ◽  
L. O. Kolodochka
Keyword(s):  
Phytoseiid Mites ◽  
Plant Associations ◽  
Species Complexes ◽  
District Center ◽  
The Family ◽  
Species Composition And Distribution ◽  
Dog Rose ◽  
The City ◽  
Species Being

This article deals with the results of study of species content and basic peculiarities of beaked mites-Phytoseiidae in plant associations of one of the regional centers of Ukraine. The species composition and distribution of mites-Phytoseiidae (Parasitiformes, Phytoseiidae) in plantations of Brovary town of Kyiv region were determined. Fourteen species of 8 genera of phytoseiid mites were found. Index of their existing and relative biotope connection of each registered species to vegetation types and plant species were computed. The study was conducted according to the results of material treatment on the territory of the mentioned city from 25 species of plants (16 species of hardy-shrub and 9 of herbaceous vegetations). The studies of distribution of plant-living mites-Phytoseiidae were conducted separately for hardy-shrub and herbaceous plants). The collection of faunistic material was executed during the vegetation of periods of 2011 and 2013. Within the city the collection of the material was conducted with hardy-shrub plants and herbaceous type of vegetation along the streets, in parks and squares of Brovary city of Kyiv region, district center, one of the satellite-cities of Kiev, the capital of Ukraine. The study of species complexes characteristics of mites was conducted with usage of data calculated on the basis of frequency index (Is), degree of relative habitat confinedness (F) (Pesenko, 1982) and domination index Paliy-Kovnatski (Di) (Shitikov, 2003). Only on one species of plant (F=1) 6 species of mites-Phytoseiidae were found – T.сotoneastri on blue spruce, T. laurae – on common spruce, T. aceri – on ash-leaved maple, P. incognitus – on dog-rose, P. soleiger – on mulberry-tree, A. caudiglans – on sea-buckthorn. These species can be related to stenoecic. The mentioned species are stenotopic only in relation to the sample of plants from the plant associations of Brovary, as in other regions these species of mites can populate the other species of plants. The rest 8 species, being registered on two or more types of plants, are related to euryoecic. Among them there is a group of 6 species with “positive tendencies to population of plants”, owning the indicators of habitat confinedness 0<F<1: A. andersoni (0,92–0,96), A. rademacheri (0,85–0,96), N. herbarius (0,92–0,96), T. tiliarum (0,66–0,77), A. pirianykae (0,73–0,99), A. clavata (0,82–0,98). The rest species, E. finlandicus и K. aberrans, have the expanded range of indicators in relation to habitat confinedness (-0,71<F<0,55 и -0,16<F<0,88), that specifies on their ability to populate the big quality of species. E. finlandicus has the negative indicator of relative habitat confinedness in relation to the plants of herbaceous morphotype that serves confirmation of the ecological peculiarity of the species detected earlier. The data of relative habitat confinedness of mites to certain species of plants shows availability of stenoecic (T.сotoneastri, T. laurae, T. aceri, P. incognitus, P. soleiger, A. caudiglans) and euryoecic species (A. andersoni, A. rademacheri, N. herbarius, E. finlandicus, K. aberrans, T. tiliarum, A. pirianykae, A. clavata). 

Impact of Organizational Culture and Teacher Performance on Quality of Learning Processes

2020 ◽  
Vol 4 (2) ◽  
pp. 95-110
Author(s):  
Buyung Syukron ◽  
Andi Thahir ◽  
Tin Amalia Fitri ◽  
Asep Rohman
Keyword(s):  
Organizational Culture ◽  
Elementary Schools ◽  
Learning Process ◽  
Teacher Performance ◽  
Work Culture ◽  
Timely Manner ◽  
Quality Learning ◽  
The City ◽  
Determining Factor

The learning process in madrasas (Islamic-based elementary schools) is seen as being able to contribute to instilling values and norms in students following Islamic teachings. The issue of organizational culture and teacher performance also becomes a determining factor in creating a quality learning process. In this research, the aim is to determine: 1) the effect of organizational culture on the quality of the learn-ing process; 2) the effect of teacher performance on the quality of the learning process; and 3) the influ-ence of organizational culture on teacher performance. Respondents in this study were all class teachers from three madrasas as a sample representing all public madrasas in the city of Bandar Lampung, Indo-nesia. The results obtained indicate that the variables of organizational culture and the quality of the learning process have an influence, with R squared of 0.67 or 67%, which is classified as moderate. This shows that madrassas have implemented predetermined work culture values, namely: a) integrity, the harmony between correct thoughts, words, and deeds; b) professionalism, working in a disciplined, competent, and timely manner with the best results; c) innovation, perfecting existing and creating new and improved techniques and ideas; d) responsibility, working thoroughly and with thought for the con-sequences; and e) being exemplary, setting a good example for others.

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