scholarly journals Validation of adapted daily dose definitions for hospital antibacterial drug use evaluation: a multicentre study

2017 ◽  
Vol 72 (10) ◽  
pp. 2931-2937 ◽  
Author(s):  
Gesche Först ◽  
Katja de With ◽  
Nadine Weber ◽  
Johannes Borde ◽  
Christiane Querbach ◽  
...  
Keyword(s):  
Drug Use ◽  
Drug Class ◽  
Anatomical Therapeutic Chemical ◽  
Antibiotic Consumption ◽  
Antibacterial Drug ◽  
Surveillance Systems ◽  
Pooled Data ◽  
Chemical Index ◽  
Hospital Antibiotic Consumption ◽  
Antibiotic Consumption Surveillance

Abstract Background The WHO/ATC (Anatomical Therapeutic Chemical) index DDD (WHO-DDD) is commonly used for drug consumption measurement. Discrepancies between WHO-DDD and actual prescribed daily doses (PDD) in hospitals have prompted alternative dose definitions adapted to doses recommended in hospital practice guidelines [recommended daily doses (RDD)]. Methods In order to validate RDD we performed modified point prevalence surveys in 24 acute care hospitals and recorded 20620 PDD of antibiotics given to 4226 adult patients on the day of the survey and the 6 preceding days. We calculated RDD and WHO-DDD and compared them with PDD. Results The rate of RDD corresponding to PDD was higher than the corresponding rate for WHO-DDD (pooled data, 55% versus 30%) and the differences were similar across the hospital sample, but varied according to drug/drug class, route of administration, indication and renal function. RDD underestimated actual consumption by 14% overall, while WHO-DDD overestimated total antibacterial consumption by 28% (pooled data; median values RDD −10% versus WHO-DDD +32%). The deviations of estimated from actual drug use volumes were largest for β-lactams (RDD −11% versus WHO-DDD +49%), in particular for penicillins (−11% versus +64%), if WHO-DDD were used. Conclusions Hospital antibiotic consumption surveillance systems using current WHO-DDD should address the uneven discrepancies between actual prescribing and consumption estimates according to drug class that may lead to misclassification in benchmark analyses. We recommend using validated RDD as a supplementary measure to the WHO-DDD for detailed analyses.

Hospital antibiotic consumption in Switzerland: comparison of a multicultural country with Europe

2011 ◽  
Vol 79 (2) ◽  
pp. 166-171 ◽  
Author(s):  
C. Plüss-Suard ◽  
A. Pannatier ◽  
A. Kronenberg ◽  
K. Mühlemann ◽  
G. Zanetti
Keyword(s):  
Antibiotic Consumption ◽  
Hospital Antibiotic Consumption

scholarly journals Informing the development of a standardised approach to measure antibiotic use in secondary care: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026792
Author(s):  
Selina Patel ◽  
Arnoupe Jhass ◽  
Susan Hopkins ◽  
Laura Shallcross
Keyword(s):  
Secondary Care ◽  
Scale Up ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Antibiotic Usage ◽  
Prescribing Patterns ◽  
Primary Data ◽  
Antibiotic Prescribing ◽  
Cochrane Central Register ◽  
Antibiotic Consumption Surveillance

IntroductionEcological and individual-level evidence indicates that there is an association between level of antibiotic exposure and the emergence and spread of antibiotic resistance. The Global Point Prevalence Survey in 2015 estimated that 34.4% of hospital inpatients globally received at least one antimicrobial. Antimicrobial stewardship to optimise antibiotic use in secondary care can reduce the high risk of patients acquiring and transmitting drug-resistant infections in this setting. However, differences in the availability of data on antibiotic use in this context make it difficult to develop a consensus of how to comparably monitor antibiotic prescribing patterns across secondary care. This review will aim to document and critically evaluate methods and measures to monitor antibiotic use in secondary care.Methods and analysisWe will search Medline (Ovid), Embase (Ovid), Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials and websites of key organisations for published reports where an attempt to measure antibiotic usage among adult inpatients in high-income hospital settings has been made. Two independent reviewers will screen the studies for eligibility, extract data and assess the study quality using the Newcastle-Ottawa scale. A description of the methods and measures used in antibiotic consumption surveillance will be presented. An adaptation of the Affordability, Practicability, Effectiveness, Acceptability, Side-effects Equity framework will be used to consider the practicality of implementing different approaches to measuring antibiotic usage in secondary care settings. A descriptive comparison of definitions and estimates of (in)appropriate antibiotic usage will also be carried out.Ethics and disseminationEthical approval is not required for this study as no primary data will be collected. The results will be published in relevant peer-reviewed journals and presented at relevant conferences or meetings where possible. This review will inform future approaches to scale up antibiotic consumption surveillance strategies to attempt to maximise impact through standardisation.PROSPERO registration numberCRD42018103375

scholarly journals Risk-adjusted antibiotic consumption in 34 public acute hospitals in Ireland, 2006 to 2014

2016 ◽  
Vol 21 (32) ◽  
Author(s):  
Ajay Oza ◽  
Fionnuala Donohue ◽  
Howard Johnson ◽  
Robert Cunney
Keyword(s):  
Administrative Data ◽  
Risk Adjustment ◽  
Antibiotic Consumption ◽  
Factors Affecting ◽  
Defined Daily Doses ◽  
Acute Hospitals ◽  
Consumption Rates ◽  
Hospital Antibiotic Consumption ◽  
Bed Days ◽  
The Impact

As antibiotic consumption rates between hospitals can vary depending on the characteristics of the patients treated, risk-adjustment that compensates for the patient-based variation is required to assess the impact of any stewardship measures. The aim of this study was to investigate the usefulness of patient-based administrative data variables for adjusting aggregate hospital antibiotic consumption rates. Data on total inpatient antibiotics and six broad subclasses were sourced from 34 acute hospitals from 2006 to 2014. Aggregate annual patient administration data were divided into explanatory variables, including major diagnostic categories, for each hospital. Multivariable regression models were used to identify factors affecting antibiotic consumption. Coefficient of variation of the root mean squared errors (CV-RMSE) for the total antibiotic usage model was very good (11%), however, the value for two of the models was poor (> 30%). The overall inpatient antibiotic consumption increased from 82.5 defined daily doses (DDD)/100 bed-days used in 2006 to 89.2 DDD/100 bed-days used in 2014; the increase was not significant after risk-adjustment. During the same period, consumption of carbapenems increased significantly, while usage of fluoroquinolones decreased. In conclusion, patient-based administrative data variables are useful for adjusting hospital antibiotic consumption rates, although additional variables should also be employed.

scholarly journals A Novel Metric System to Quantify Antibiotic Consumption in Paediatric Population: A Hospital Based, Biphasic Pilot Study

Discoveries ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e119
Author(s):  
Shah Newaz Ahmed ◽  
◽  
Ratinder Jhaj ◽  
Ritendra Patidar ◽  
Mahendra Dangi ◽  
...  
Keyword(s):  
Body Weight ◽  
Anatomical Therapeutic Chemical ◽  
Adult Population ◽  
Healthcare Delivery ◽  
Paediatric Population ◽  
Antibiotic Consumption ◽  
The Body ◽  
World Health ◽  
Defined Daily Dose ◽  
Standard Unit

Background: The Anatomical Therapeutic Chemical Classification / Defined Daily Dose (ATC/DDD) system recommended by World Health Organization is accepted worldwide as the standard method of quantification of drug consumption. However, owing to individual variation in body weight, the ATC/DDD system cannot be used for comparison across paediatric population. Objective: This study aimed to develop a novel metric system for standard quantification of antibiotic consumption in paediatric population. Method: The standard unit of drug quantification in adult population is DDD/100 patient days (PD). We conceived a new unit of DDD/1000 kg-days (KD) where KD is the product of the body weight and length of hospital stay of an individual patient. We simulated the quantification and comparison of drugs in a computer model of five virtual paediatric hospitals (H1 to H5, n=100, 200, 100, 100, 100 respectively). We re-applied the metric system on two, real world, hospital-based, time cohorts (TC) (TC18, n=38 and TC19, n=47) of 2 weeks each, in two consecutive years. Results: The body weights (mean±SD) in H1-H5 were 5.7±3.0, 5.7±2.8, 25.3±8.5, 20.6±11.7 and 19.8±11.4 kg, respectively. The antibiotic consumption in terms of DDD/100 PD and DDD/1000 KD in the five hospitals was 1.26, 1.20, 5.52, 4.41 and 2.00, and 2.24, 2.14, 2.22, 2.17 and 1.06 respectively. In TC18 and TC19, the mean body weight, DDD/100 PD and DDD/1000 KD were 12.24±13.17, 30.93, 20.34 and 19.51±12.28, 11.99, 6.23, respectively. Conclusion: DDD/1000 kg-days is a potential standard unit for drug quantification in paediatric population independent of weight distribution and size of the study sample. The universal application and comparison across diverse samples can generate useful information for resource allocation, anti-microbial stewardship, disease burden and drug use, and can help in taking policy decisions to improve healthcare delivery in the paediatric population.

scholarly journals Impact of Outpatient Antibiotic Use on Carriage of Ampicillin-ResistantEscherichia coli

2010 ◽  
Vol 55 (3) ◽  
pp. 1135-1141 ◽  
Author(s):  
Matthew H. Samore ◽  
Claude Tonnerre ◽  
Elizabeth Lyon Hannah ◽  
Gregory J. Stoddard ◽  
Robert J. Borotkanics ◽  
...  
Keyword(s):  
Drug Class ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Clinic Visit ◽  
Individual Risk ◽  
Competitive Balance ◽  
Household Level ◽  
E Coli ◽  
Group 2 ◽  
Group 1

ABSTRACTStudies about the relationship between antibiotic consumption and carriage of antibiotic-resistantEscherichia coliin individual patients have yielded conflicting results. The goal of this study was to identify individual- and household-level factors associated with carriage of ampicillin (AMP)-resistantE. coliduring consumption of a course of oral antibiotics. We enrolled outpatients and their families in a prospective household study of AMP-resistant or AMP-susceptibleE. colicarriage. Two kinds of index patients were identified. Group 1 consisted of outpatients who were being initiated on a new antibiotic course at the time of a clinic visit, and group 2 consisted of outpatients not starting antibiotics. Each participant was asked to submit three stool swab samples (at baseline, week 1, and week 4) and to complete a questionnaire. Antimicrobial susceptibility testing was performed on each phenotypically distinctE. colicolony. The study included 149 group 1 households (total, 570 participants) and 38 group 2 households (total, 131 participants). AMP-resistantE. coliwas recovered from 29% of stool samples. Observed associations with antibiotic exposure varied by drug class. Penicillins, which were the most frequently prescribed drug class, were associated with a modest increase in AMP-resistantE. colicarriage and a modest decrease in AMP-susceptibleE. colicarriage. Neither change by itself was statistically significant. Macrolides were associated with reduced carriage of both AMP-resistantE. coliand AMP-susceptibleE. coli(P< 0.05). Both AMP-resistant and AMP-susceptibleE. colidemonstrated household clustering (P< 0.001). In summary, the overall effect of antibiotics on individual risk of carriage of AMP-resistantE. coliwas small. However, even a modest alteration of the competitive balance between AMP-resistant and AMP-susceptibleE. colimay promote population spread of resistantE. coli. Examining changes in both resistant and susceptible organisms in antibiotic-treated individuals and their close contacts improves understanding of antibiotic selection pressure.

scholarly journals Self-medication among nursing workers from public hospitals

2009 ◽  
Vol 17 (6) ◽  
pp. 1015-1022 ◽  
Author(s):  
Aline Reis Rocha Barros ◽  
Rosane Harter Griep ◽  
Lúcia Rotenberg
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
Public Hospitals ◽  
Sectional Study ◽  
Therapeutic Group ◽  
Temporary Work ◽  
Self Medication ◽  
Team Members ◽  
Psychiatric Disturbances ◽  
Chemical Index ◽  
Planning Strategies

This study describes the prevalence of self-medication and associated factors among nursing workers. This epidemiological sectional study included 1,509 working nurses from two public hospitals in Rio de Janeiro, Brazil. The medications were identified and classified according to the Anatomical Therapeutic Chemical Index. The self-medication prevalence was 24.2% and the most reported anatomical group treated was the nervous system, while the therapeutic group included analgesics. Self-medication was more prevalent among young people, individuals with minor psychiatric disturbances, non-hypertensive individuals, those who did not exercise, those who reported a disease or injury in the last 15 days, with the highest number of self-diagnosed diseases, nurses, professionals with temporary work contracts and those highly involved with their work. Self-medication is a frequent practice among the nursing team members and is associated with factors that should be taken into account when planning strategies aimed at improving workers' health conditions.

Evaluating consumption and expenditure patterns of antibiotics in tablet and capsule dosage forms: Pakistan Antibiotic Consumption Surveillance (PACS)

2020 ◽  
Vol 50 (1) ◽  
pp. 36-41
Author(s):  
Zikria Saleem ◽  
Mohamed Azmi Hassali ◽  
Furqan Khurshid Hashmi ◽  
Shama Qaisar ◽  
Mahnoor Ahmad ◽  
...  
Keyword(s):  
Antibiotic Consumption ◽  
Dosage Forms ◽  
Expenditure Patterns ◽  
Antibiotic Consumption Surveillance

scholarly journals How to measure hospital antibiotic consumption: comparison of two methods from data surveillance in France

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Florence Stordeur ◽  
Katiuska Miliani ◽  
Ludivine Lacavé ◽  
Anne-Marie Rogues ◽  
Catherine Dumartin ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Strongly Correlated ◽  
Surveillance Network ◽  
Healthcare Facilities ◽  
Clinical Ward ◽  
Hospital Antibiotic Consumption ◽  
Data Surveillance ◽  
National Databases ◽  
Spearman’S Correlation

Abstract Background Antibiotic use (ABU) surveillance in healthcare facilities (HCFs) is essential to guide stewardship. Two methods are recommended: antibiotic consumption (ABC), expressed as the number of DDD/1000 patient-days; and prevalence of antibiotic prescription (ABP) measured through point prevalence surveys. However, no evidence is provided about whether they lead to similar conclusions. Objectives To compare ABC and ABP regarding HCF ranking and their ability to identify outliers. Methods The comparison was made using 2012 national databases from the antibiotic surveillance network and prevalence study. HCF rankings according to each method were compared with Spearman’s correlation coefficient. Analyses included the ABU from entire HCFs as well as according to type, clinical ward and by antibiotic class and specific molecule. Results A total of 1076 HCFs were included. HCF rankings were strongly correlated in the whole cohort. The correlation was stronger for HCFs with a higher number of beds or with a low or moderate proportion of acute care beds. ABU correlation between ABC or ABP was globally moderate or weak in specific wards. Furthermore, the two methods did not identify the same outliers, whichever HCF characteristics were analysed. Correlation between HCF ranking varied according to the antibiotic class. Conclusions Both methods ranked HCFs similarly overall according to ABC or ABP; however, major differences were observed in ranking of clinical wards, antibiotic classes and detection of outliers. ABC and ABP are two markers of ABU that could be used as two complementary approaches to identify targets for improvement.

The Epidemiology of Cocaine Use Among Hispanic Individuals: Findings From the 2015–2018 National Survey of Drug Use and Health

2020 ◽  
pp. 154041532097163
Author(s):  
Andrew Yockey ◽  
Shanna Stryker
Keyword(s):  
Drug Use ◽  
National Survey ◽  
Social Groups ◽  
Risky Behaviors ◽  
National Sample ◽  
Health Prevention ◽  
Cocaine Use ◽  
Pooled Data ◽  
The Past ◽  
Prevention Messages

Cocaine use disproportionately affects several social groups, including ethnic and sexual minorities. The present study sought to identify the epidemiology of cocaine use among a national sample of Hispanic young adults using pooled data from the 2015–2018 National Survey of Drug Use and Health. Weighted analyses were used to identify correlates to past-year cocaine use. Results revealed that 4.11% ( n = 729) of individuals used cocaine in the past year. Individuals who identified as gay/lesbian or bisexual, who drove under the influence of alcohol in the past year, and who reported prior drug use were at risk of cocaine use. Of concern, nearly 10% of gay/lesbian Hispanic individuals report having used cocaine in the past year. Furthermore, cocaine use was associated with other risky behaviors; 41.1% of LSD (Lysergic acid diethylamide) users also reported cocaine use, and 18.2% of cocaine users reported having driven under the influence of alcohol within the past year. Findings from the present study may inform harm reduction efforts and health prevention messages.

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