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 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.

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.

scholarly journals Analysis of Antibiotic Use Patterns and Trends Based on Procurement Data of Healthcare Institutions in Shaanxi Province, Western China, 2015–2018

2020 ◽  
Vol 17 (20) ◽  
pp. 7536
Author(s):  
Sen Xu ◽  
Shengfang Yuan ◽  
John Alimamy Kabba ◽  
Chen Chen ◽  
Wenchen Liu ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Anatomical Therapeutic Chemical ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Shaanxi Province ◽  
Western China ◽  
World Health ◽  
Fourth Generation ◽  
Defined Daily Dose ◽  
Antibiotic Utilization

Overuse of antibiotics has caused a series of global problems, especially in the underdeveloped western regions where healthcare systems are fragile. We used antibiotic procurement data of all healthcare institutions to analyze the total amount, patterns and trends of antibiotic use in Shaanxi Province, western China between 2015 and 2018. Antibiotic utilization was quantified using the standard Anatomical Therapeutic Chemical (ATC)/Defined daily dose (DDD) methodology. The World Health Organization’s “Access, Watch and Reserve” (AWaRe) classification and European Surveillance of Antimicrobial Consumption (ESAC) drug-specific quality indicators were also adopted to evaluate the appropriateness and quality of antibiotic utilization. Overall, antibiotic consumption decreased from 11.20 DID in 2015 to 10.13 DID (DDDs per 1000 inhabitants per day) in 2016, then increased to 12.99 DID in 2018. The top three antibiotic categories consumed in 2018 were J01C (penicillins) 33.58%, J01D (cephalosporins) 29.76%, and J01F (macrolides) 19.14%. Parenteral antibiotics accounted for 27.41% of the total consumption. The largest proportion of antibiotic use was observed in primary healthcare institutions in rural areas, which accounts for 51.67% of total use. Consumption of the Access group, the Watch group, the Reserve group of antibiotics was 40.31%, 42.28% and 0.11%, respectively. Concurrently, the consumption of J01D and the percentage of J01 (DD + DE) (third and fourth generation cephalosporins) were at a poor level according to the evaluation of ESAC quality indicators. The total antibiotic consumption in Shaanxi Province had been on an upward trend, and the patterns of antibiotic use were not justified enough to conclude that it was rational. This is partly because there was high preference for the third and fourth generation cephalosporins and for the Watch group antibiotics.

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 use in Albania between 2011 and 2012

2015 ◽  
Vol 9 (01) ◽  
pp. 094-098 ◽  
Author(s):  
Iris Hoxha ◽  
Admir Malaj ◽  
Ledjan Malaj
Keyword(s):  
Antibiotic Use ◽  
World Health ◽  
Measurement Unit ◽  
Defined Daily Dose ◽  
Anatomic Therapeutic Chemical ◽  
Daily Dose ◽  
Health Institutions ◽  
Health Organization ◽  
Official Data

Introduction: Health institutions in Albania have recently reported an increase in antibiotic misuse and microbial resistance. Until now, there have been no comprehensive studies that analyzed the overall use of antibiotics in Albania. The aim of this study was to analyze the overall antibiotic use in Albania between 2011 and 2012, using standardized methodology of measurement, based on World Health Organization guidelines. Methodology: Data from 2011 and 2012 on antibiotic use from ambulatory and hospital sector were examined. Antibiotics were divided based on anatomic therapeutic chemical classification. Defined daily dose (DDD) for each drug was assigned, and DDD per 1,000 inhabitants per day (DID) was used as a measurement unit. In cases of antibiotic combinations for which DDD were not available, unit doses were assigned. Results: In 2011–2012, total antibiotic use decreased from 24.25 to 20.66 DID. Penicillin’s were the most used antibiotic class, with 10.62 DID (2011) and 10.51 DID (2012). Tetracycline use decreased from 5.45 DID (2011) to 0.98 DID (2012). Macrolides increased from 1.36 to 1.88 DID, quinolones from 1.72 to 2.51 DID. The overall antibiotic use was significantly higher than the reimbursed antibiotic use – 3.17 DID (2011) and 2.79 DID (2012) – based on the official data for the same period. Conclusions: This study enables policymakers to further analyze the quality of antibiotic prescriptions and draw comparisons to other countries. The analyzed data suggest there are different factors influencing out-of-pocket use of antibiotics and wrongly prescribed antibiotics. Further studies are necessary to evaluate these factors.

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 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.

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

2020 ◽  
Author(s):  
Franka Lestin-Bernstein ◽  
Ramona Harberg ◽  
Ingo Schumacher ◽  
Lutz Briedigkeit ◽  
Oliver Heese ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Therapy ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Selective Reporting ◽  
Care Hospital ◽  
Beta Lactams ◽  
Interventional Study ◽  
Narrow Spectrum ◽  
The Impact

Abstract Background:Antimicrobial stewardship (AMS) strategies worldwide focus on optimised antibiotic use. 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/oral cefalexin, trimethoprim-sulfamethoxazole, clindamycin, gentamicin and rifampin/fosfomycin; instead of reporting all tested antibiotics during the year before the intervention and in the reference clinic. The impact of the intervention was analysed by monitoring antibiotic consumption (recommended daily dose/100 occupied bed days: RDD/100 BD).Results:MSSA-antibiograms were reported for 2836 patients. Total use of narrow-spectrum beta-lactams more than doubled during the intervention (from 1.2 to 2.8 RDD/100 BD, P<0.001; P<0.001 compared to the reference clinic); the percentage of total antibiotic use increased from 2.6% to 6.2%. A slight, but significant increase in the use of trimethoprim-sulfamethoxazole was also observed (+ 0.37 RDD/100 BD).There was no decrease in antibiotics withdrawn from the antibiogram, probably as a consequence of their wide use for indications other than S. aureus infections.Conclusions:As narrow-spectrum beta-lactams are not widely used for other infections, there is a strong indication that selective reporting guided clinicians to optimised antibiotic therapy of S. aureus infections.As useful AMS tool, we recommend implementing selective reporting rules into the national/international standards for susceptibility reporting.

scholarly journals Broad Spectrum project: factors determining the quality of antibiotic use in primary care: an observational study protocol from Italy

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e038843
Author(s):  
Peter Konstantin Kurotschka ◽  
Alice Serafini ◽  
Marco Massari ◽  
Roberto Da Cas ◽  
Adolfo Figueiras ◽  
...  
Keyword(s):  
Drug Prescription ◽  
National Health System ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Prescription Data ◽  
Italian Region ◽  
Related Factors ◽  
Knowledge And Attitudes ◽  
The Impact

IntroductionThe overuse of antibiotics is causing worldwide spread of antimicrobial resistance (AMR). Compared with other countries, Italy has both high antibiotic consumption rates and high rates of AMR. Due to the fact that around 90% of antibiotics are prescribed by general practitioners (GPs), this study aims to measure the impact of knowledge, attitudes and sociodemographic and workplace-related factors on the quality of antibiotic prescriptions filled by GPs in the Italian Region of Sardinia.Methods and analysisKnowledge, attitude, sociodemographic and workplace-related factors deemed to influence physicians prescribing behaviour will be evaluated in a cross-sectional study conducted among all GPs of the Italian Region of Sardinia (n=1200). A knowledge and attitudes questionnaire (Knowledge and Attitudes on Antibiotics and Resistance - Italian version: ITA-KAAR) accompanied by a sociodemographic form will be linked to drug prescription data reimbursed by the National Health System. European Surveillance of Antibiotic Consumption quality indicators for outpatient antibiotic use will be calculated from drug prescription records. Every GP will be deemed to have demonstrated an adequate quality of prescriptions of antibiotics if half of the indicator score plus one is better than the median of the region. A multivariate Poisson regression model with robust variance estimation will be used to evaluate the impact of the determinants of antibiotic prescriptions on the actual prescribing quality of each physician.Ethics and disseminationThe project has been approved by the ethics committee of the Regional Health Trust of Sardinia (176/2019/CE, 24 September 2019). The results will be useful to inform evidence-based interventions to tackle irrational antibiotic use in the community.

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
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