STUDI PENGGUNAAN ANTIBIOTIK PASIEN PNEUMONIA ANAK DENGAN METODE DDD DAN DU 90%

Pneumonia is one of the most common respiratory infections. The treatment of pneumonia mostly uses broad-spectrum empirical antibiotics that are susceptible to resistance. One of the efforts to reduce antibiotic resistance is to use antibiotics wisely which can be done by regularly evaluating the quantitative and qualitative use of antibiotics. The purpose of this study was to determine the quantity of consumption and the type of antibiotic used in patients pneumonia child inpatient ward at Hospital Mitra Paramedika Yogyakarta (MPY) and Yadika Pondok Bambu Jakarta (YPBJ) by DDD (Defined Daily Dose) and DU (Drug utility) 90%. This is a descriptive study period June 2017 - April 2020 in pediatric patients aged 1 - 18 years with a diagnosis of pneumonia. Sampling was performed at the Medical Record Installation. The Data taken were antibiotic type, dosage regimen, medication route, antibiotic duration (day), and hospital stay (day) as well as patient demographic data (age, type sex) .There are differences in the pattern of antibiotic use between YPBJ and MPY. Comparison of DDD and DU 90% may be due to differences in standard of therapy used by physicians, antibiotic resistance, differences in germ maps and hospital formularies.

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Evaluasi Penggunaan Antibiotik Pada Pasien Anak Rawat Inap di RSD Dr. Soebandi Jember

Jurnal Farmasi Galenika (Galenika Journal of Pharmacy) ◽

10.22487/j24428744..v.i.14976 ◽

2020 ◽

Author(s):

Sinta Rachmawati ◽

Dewi Khurmi Masito ◽

Ema Rachmawati

Keyword(s):

Antibiotic Resistance ◽

Quantitative Evaluation ◽

Pediatric Patients ◽

Anatomical Therapeutic Chemical ◽

Antibiotic Use ◽

Defined Daily Dose ◽

Resistance Risk ◽

Condition Evaluation ◽

Daily Dose ◽

Active Substances

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)

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Indicators for the monitoring of antibiotic use

Journal of Infection Prevention ◽

10.1177/1757177410363357 ◽

2010 ◽

Vol 11 (4) ◽

pp. 124-126

Author(s):

CE Curtis

Keyword(s):

Antibiotic Resistance ◽

Antibiotic Use ◽

Antibiotic Prescribing ◽

Defined Daily Dose ◽

Daily Dose ◽

Prescribing Practice

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.

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Defined Daily Dose and Cost of Therapy of Empirical Ceftriaxone Pre- and Post-Antimicrobial Stewardship Program Model Implementation in Sepsis Patients in A Tertiary Hospital in Indonesia

International Journal of Integrated Health Sciences ◽

10.15850/ijihs.v7n2.1693 ◽

2019 ◽

Vol 7 (2) ◽

pp. 96-101

Author(s):

Uun Sumardi ◽

Anggra Filani ◽

Evan Susandi ◽

Ida Parwati

Keyword(s):

Antibiotic Resistance ◽

General Hospital ◽

Antibiotic Use ◽

Tertiary Hospital ◽

Defined Daily Dose ◽

Post Intervention ◽

Antibiotic Development ◽

Stewardship Program ◽

Daily Dose ◽

Quasi Experimental

Objective: Antibiotic resistance requires substantial responses through two mechanisms: new antibiotic development and smart antibiotic use. Antibiotic Stewardship Program (ASP) is one of the responses that reduce the overall antibiotics use and prevent the overuse of antibiotics to avoid antibiotic resistance. The purpose of this study was to assess the difference in defined daily dose (DDD) and the cost of therapy (COT) for empirical ceftriaxone therapy in sepsis patients pre- and post-ASP model implementation in Dr. Hasan Sadikin General Hospital, Bandung. Methods: A pre- and post-intervention quasi-experimental study on ASP model implementation in empirical ceftriaxone therapy provided to sepsis patients treated in the intensive or semi-intensive care units was performed from December 2015 to July 2016 using the Mann Whitney test and t-test. The DDD was calculated as DDD/100 patient-days, while the COT was calculated as the COT/patient-day. The ASP model intervention implemented in these units applied 2 main strategies: ceftriaxone use restriction and ceftriaxone therapy duration audit. Results: Participants of this study consisted of 112 sepsis subjects (n=112) with 55 subjects in the pre-ASP group and 57 subjects in the post-ASP group. The mean DDD/100 patient-days in the post-ASP subject was lower than that of the pre-ASP (16.3±4.3 and 45.8±16.8; p=0.018). The median COT/patient-days in post-ASP subject was IDR 42,000 (IDR 14.000–42.000), which was lower than that of the pre-ASP group of IDR 84.000 (IDR 28.000–420.000, p=0.001). Conclusion: The differences in the DDD/100 patient-day and COT/patient-day values between the pre-ASP and post-ASP are significant. The ASP model applied in Dr. Hasan Sadikin General Hospital, Bandung leads to a smart use of ceftriaxone and reduces costs for the empiric ceftriaxone therapy in sepsis patients

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EVALUATION OF ANTIBIOTICS USED IN PATIENTS WITH ACUTE RESPIRATORY INFECTIONS IN A HOSPITAL

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2019.v12i3.30890 ◽

2019 ◽

pp. 480-483

Author(s):

PRICELLA AQWILLA GINTING ◽

AZIZAH NASUTION ◽

KHAIRUNNISA KHAIRUNNISA

Keyword(s):

Acute Respiratory Infection ◽

Dosage Form ◽

Respiratory Infections ◽

Antibiotic Use ◽

Defined Daily Dose ◽

Health Coverage ◽

Number Of Patients ◽

Daily Dose ◽

Universal Health ◽

Chemical Code

Objective: This study evaluated the use of antibiotics in the treatment of patients with acute respiratory infection (ARI) in the outpatients installation in Bunda Thamrin General Hospital, Medan. Methods: This prospective descriptive cohort study analyzed the use of antibiotics provided to patients with ARI using Indonesian universal health coverage known as Badan Penyelenggara Jaminan Sosial claims (n=130) in outpatients installations from March to May 2018. The characteristics of the patients were organized and descriptively analyzed in Excel and SPSS programs. The antibiotics provided were grouped according to the Anatomical Therapeutical Chemical code and class; then, the dosage form, defined daily dose (DDD) units, was converted into milligrams. DDD calculation was done by dividing the total DDD usage with the total number of patients. Results: Mean age of the patients was 32.12±10.579 years. The highest quantity of antibiotic use in DDD/1000 patients-day units was cefixime reaching 1,897.435 mg DDD KPRJ. Conclusions: Cefixime was the most widely available antibiotic for the treatment of ARI patients.

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Evaluasi Penggunaan Antibiotik pada Pasien Anak Rawat Inap di RSD Dr. Soebandi Jember

Jurnal Farmasi Galenika (Galenika Journal of Pharmacy) ◽

10.22487/j24428744.2020.v6.i2.14976 ◽

2020 ◽

Vol 6 (2) ◽

Author(s):

Sinta Rachmawati ◽

Dewi Khurmi Masito ◽

Ema Rachmawati

Keyword(s):

Antibiotic Resistance ◽

Quantitative Evaluation ◽

Pediatric Patients ◽

Anatomical Therapeutic Chemical ◽

Antibiotic Use ◽

Defined Daily Dose ◽

Resistance Risk ◽

Condition Evaluation ◽

Daily Dose ◽

Active Substances

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

International Journal of Applied Pharmaceutics ◽

10.22159/ijap.2021.v13s1.y0067 ◽

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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SYSTEMS APPROACH FOR ANTIBIOTICS IN COLORECTAL SURGERY IN GROWING ANTIMICROBIAL RESISTANCE BACKGROUND

Koloproktologia ◽

10.33878/2073-7556-2019-18-3-49-54 ◽

2019 ◽

Vol 18 (3(69)) ◽

pp. 49-54

Author(s):

Yu. M. Stojko ◽

V. G. Gusarov ◽

D. A. Kolozyan ◽

A. L. Levchuk ◽

A. V. Maksimenkov

Keyword(s):

Antibiotic Resistance ◽

Colorectal Surgery ◽

Antibiotic Therapy ◽

Antibiotic Prophylaxis ◽

Systems Approach ◽

Antibiotic Use ◽

Defined Daily Dose ◽

Empirical Antibiotic Therapy ◽

Septic Complications ◽

Extended Spectrum Beta Lactamases

AIM: to reduce antibiotic resistance of infectious agents in colorectal surgery using optimal antibiotic therapy. PATIENTS AND METHODS: single-center interventional study with retrospective control has been done. Start point of intervention was January 2017, when it was provided direct administrative control of perioperative antibiotic prophylaxis protocols and empirical antibiotic therapy. The study included 200 patients after colorectal surgery in 2016-2017. Patients divided in two groups: in 2016 y – control (A), in 2017 – interventional one (B). RESULTS: significant decrease was detected in total antibiotic use from 16.1 to 12.2 defined daily dose (DDD) and in duration of antibiotic prophylaxis from 5.5 to 1.9 days (p<0.001). Incidence of infection caused by multi-resistant strains reduced from 84.3% to 50% (p<0.001). Analysis of etiology septic complications in colorectal patients showed a decrease in the number of Enterobacteriales, producing extended-spectrum beta-lactamases (ESBL) from 33.3% to 11.8% (р<0.01). The incidence of carbapenem-resistant Klostridium pneumoniae reduced from 7.8% до 0%, р=0.031. ESKAPE group pathogens decreased from 24 (47.1%) to 12 (17.7%), р<0.001. No difference in postoperative infectious morbidity between groups was detected (32.9% vs 31.0%, р=0.88). Incidence of antibiotic-associated diarrhea decreased from 5% to 0% (р=0.03). CONCLUSION: direct control of antibiotic prophylaxis protocols and empirical antibiotic therapy allowed to decrease the rate of antibiotic use and to decrease rate of infection complications caused by antibiotic resistance strains.

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Analysis of antibiotic consumption for treating respiratory tract infections in children and compliance with the national clinical guidelines

Medicinski pregled ◽

10.2298/mpns1410282l ◽

2014 ◽

Vol 67 (9-10) ◽

pp. 282-289 ◽

Cited By ~ 3

Author(s):

Dragana Lakic ◽

Ivana Tadic ◽

Marina Odalovic ◽

Ljiljana Tasic ◽

Ana Sabo ◽

...

Keyword(s):

Respiratory Tract ◽

Respiratory Tract Infections ◽

Respiratory Infections ◽

Acute Otitis Media ◽

Antibiotic Consumption ◽

Defined Daily Dose ◽

Upper Respiratory Tract ◽

National Guidelines ◽

Daily Dose ◽

Tract Infections

Introduction. Respiratory infections are the most common infections in children. The aims of the study were to analyze the use of antibiotics for respiratory infections in the period 2008 - 2010 in children?s population in region of Nis and to estimate the rational use of antibiotics in relation to the recommendations of the National Guidelines for physicians in primary care. Material and methods. Data source was a Pharmacy Nis database. Antibiotics prescriptions were selected for the following diagnoses: H65-H75 (acute otitis media, mastoiditis), J01 (acute sinusitis), J02-J03 (tonsillopharyngitis), J12-J18 (community acquired pneumonia), J20 (acute bronchitis), J32 (chronic sinusitis), J42 (chronic bronchitis). Antibiotic consumption was expressed in defined daily dose/1000 inhabitants/day. Results. The most widely prescribed antibiotic for the treatment of upper respiratory tract infections in children during the three years was amoxicillin (34.63; 32.50 and 31.00 defined daily dose/1000 inhabitants/day in 2008, 2009 and 2010, respectively). In the treatment of infections of the middle ear and mastoid, the combination of amoxicillin and clavulanic acid, was the most prescribed antibiotics (60% of total consumption of antibiotics for this indication). Azithromycin was the most widely prescribed antibiotic for the treatment of lower respiratory tract infections in children during the observed period (6.92; 8.20 and 7.18 defined daily dose/1000 inhabitans/day in 2008, 2009 and 2010, respectively). Conclusion. Recommendations of national guidelines are not complied with the treatment of upper and lower respiratory infections in the children population in region of Nis. This could be a sign of potentially irrational use of antibiotics that need to be further examined. Education of physicians can influence irrational use of antibiotics.

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

Orvosi Hetilap ◽

10.1556/oh.2013.29632 ◽

2013 ◽

Vol 154 (24) ◽

pp. 947-956 ◽

Cited By ~ 5

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.

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

Antibiotics ◽

10.3390/antibiotics10040397 ◽

2021 ◽

Vol 10 (4) ◽

pp. 397

Author(s):

Ana Tomas ◽

Nebojša Pavlović ◽

Nebojša Stilinović ◽

Olga Horvat ◽

Milica Paut-Kusturica ◽

...

Keyword(s):

Broad Spectrum ◽

Anatomical Therapeutic Chemical ◽

Antibiotic Use ◽

Annual Reports ◽

Antibiotic Prescribing ◽

Defined Daily Dose ◽

Increasing Trend ◽

Daily Dose ◽

Total Utilization ◽

Third Generation Cephalosporins

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.

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