Patterns Of Antibiotic Use Research Articles

Antimicrobial prescribing for children in China: data from point prevalence surveys in 18 tertiary centres in China in 2016–2017

ObjectivesThe reports on evaluating the classification of antibiotic agents prescribed for Chinese children by combining WHO’s and China’s administrative categories were rare. This study aimed to investigate the pattern of...

Microbial pattern and antibiotic resistance in Ardabil city hospitals

Introduction: Antibiotic arbitrary use by increasing resistance changed to a growing issue in the 21st century and its optimal use in hospital could be essential for reducing health system costs and drug side effects. Objectives: The aim of this study was to investigate the pattern of antibiotic use in prescribed prescription. Patients and Methods: This was a cross-sectional study that has been done on 300 prescriptions which selected randomly form Ardabil city hospitals. The anatomical therapeutic chemical classification system with defined daily doses (ATC/DDD) standard measurement method recommended by World Health Organization (WHO) was conducted in the study. The amount uses rate of each medication calculated by DDD/100 bed days. Data collected by a checklist and analyzed by statistical methods in SPSS version 21. Results: The highest prescribed antibiotic was ciprofloxacin with 32% and the total antibiotics uses rate during study period was 44/95 DDD/100 Bed days. The mean number of drugs and prescribed antibiotics in intensive care unit (ICU) ward was more than other wards. However, comparing the rate of antibiotics use between wards based on ATC/DDD method showed that the infection ward with 62.9 was more than other wards. The most form of used antibiotics with 69% was in the form of Ampule and in intravenously method with 64% in all wards. Conclusion: The results of this study showed that the most used antibiotics by considering the studied method, prescribed dose and the hospitalized days were in internal and surgery ward respectively but according ATC/DDD method the most used antibiotics was in infection ward.

Antibiotic use during the first 6 months of COVID-19 pandemic in Iran: A large-scale multi-centre study.

What is known and objectiveAlthough antibiotics are ineffective against viral infections, epidemiological studies have revealed that the COVID‐19 pandemic resulted in the overuse of antibiotics and disruption of antimicrobial stewardship programmes. We investigated the pattern of antibiotic use during the first 6 months of the COVID‐19 pandemic in Iran.MethodsA multi‐centre retrospective study was designed to investigate the use of 16 broad‐spectrum antibiotics in 12 medical centres. The rate of antibiotic use was calculated and reported based on the Defined Daily Dose (DDD) per 100 hospital bed‐days. The bacterial co‐infection rate was also reported.Results and discussionTotally, 43,791 hospitalized COVID‐19 patients were recruited in this study. It was found that 121.6 DDD of antibiotics were used per 100 hospital bed‐days, which estimated that each patient received approximately 1.21 DDDs of antibiotics every day. However, the bacterial co‐infections were detected only in 14.4% of the cases. A direct correlation was observed between the rate of antibiotic use and mortality (r[142] = 0.237, p = 0.004). The rate of antibiotic consumption was not significantly different between the ICU and non‐ICU settings (p = 0.15).What is new and conclusionIn this study, widespread antibiotic use was detected in the absence of the confirmed bacterial coinfection in COVID‐19 patients. This over‐consumption of broad‐spectrum antibiotics may be associated with increased mortality in hospitalized COVID‐19 patients, which can be an alarming finding.

Prevalence of bacterial coinfection and patterns of antibiotics prescribing in patients with COVID-19: A systematic review and meta-analysis.

Evidence around prevalence of bacterial coinfection and pattern of antibiotic use in COVID-19 is controversial although high prevalence rates of bacterial coinfection have been reported in previous similar global viral respiratory pandemics. Early data on the prevalence of antibiotic prescribing in COVID-19 indicates conflicting low and high prevalence of antibiotic prescribing which challenges antimicrobial stewardship programmes and increases risk of antimicrobial resistance (AMR). To determine current prevalence of bacterial coinfection and antibiotic prescribing in COVID-19 patients. OVID MEDLINE, OVID EMBASE, Cochrane and MedRxiv between January 2020 and June 2021. English language studies of laboratory-confirmed COVID-19 patients which reported (a) prevalence of bacterial coinfection and/or (b) prevalence of antibiotic prescribing with no restrictions to study designs or healthcare setting. Adults (aged ≥ 18 years) with RT-PCR confirmed diagnosis of COVID-19, regardless of study setting. Systematic review and meta-analysis. Proportion (prevalence) data was pooled using random effects meta-analysis approach; and stratified based on region and study design. A total of 1058 studies were screened, of which 22, hospital-based studies were eligible, compromising 76,176 of COVID-19 patients. Pooled estimates for the prevalence of bacterial co-infection and antibiotic use were 5.62% (95% CI 2.26-10.31) and 61.77% (CI 50.95-70.90), respectively. Sub-group analysis by region demonstrated that bacterial co-infection was more prevalent in North American studies (7.89%, 95% CI 3.30-14.18). Prevalence of bacterial coinfection in COVID-19 is low, yet prevalence of antibiotic prescribing is high, indicating the need for targeted COVID-19 antimicrobial stewardship initiatives to reduce the global threat of AMR.

Pattern of Antibiotic Use among Hospitalized Patients according to WHO Access, Watch, Reserve (AWaRe) Classification: Findings from a Point Prevalence Survey in Bangladesh.

For supporting antibiotic stewardship interventions, the World Health Organization (WHO) classified antibiotics through the AWaRe (Access, Watch, and Reserve) classification. Inappropriate use of antimicrobials among hospital-admitted patients exposes them to the vulnerability of developing resistant organisms which are difficult to treat. We aimed to describe the proportion of antibiotic use based on the WHO AWaRe classification in tertiary and secondary level hospitals in Bangladesh. A point prevalence survey (PPS) was conducted adapting the WHO PPS design in inpatients departments in 2021. Among the 1417 enrolled patients, 52% were female and 63% were from the 15–64 years age group. Nearly 78% of patients received at least one antibiotic during the survey period. Third-generation cephalosporins (44.6%), penicillins (12.3%), imidazoles (11.8%), aminoglycosides (7.2%), and macrolides (5.8%) were documented as highly used antibiotics. Overall, 64.0% of Watch, 35.6% of Access, and 0.1% of Reserve group antibiotics were used for treatment. The use of Watch group antibiotics was high in medicine wards (78.7%) and overall high use of Watch antibiotics was observed at secondary hospitals (71.5%) compared to tertiary hospitals (60.2%) (p-value of 0.000). Our PPS findings underscore the need for an urgent nationwide antibiotic stewardship program for physicians including the development and implementation of local guidelines and in-service training on antibiotic use.

Pattern of Antibiotic Use in the Perinatal Period in a Public University Hospital in Romania.

Background and Objectives: Antibiotics are the most frequently prescribed drugs in hospitals and their prescription is increased during pregnancy and labor. There are limited data about this issue, and the safe use of antibiotics in pregnancy and antibiotic resistance remains a concern. The aim of the study is to evaluate the use of antibiotics among pregnant women attending hospital for five years. Materials and Methods: Antibiotic consumption and treatment information of patients were retrospectively collected from a hospital software program and expressed as defined daily dose (DDD) according to the World Health Organization (WHO) methodology for inpatients between 2017 and 2021. We evaluated antibiotic prescription by name, classes, and Food and Drug Administration (FDA) categories. Results: Antibiotic consumption shows a decreasing trend between 2017 and 2019, but an increasing one between 2020 and 2021. Ceftriaxone was the most prescribed antibiotic in each year, followed by cefixime, amoxicillin, metronidazole, cefuroxime, ampicillin, and ciprofloxacin. We noticed that first- and fourth-generation cephalosporins were not prescribed to these patients. A very small percentage of women in this study received antibiotics such as aminoglycosides; fluoroquinolones were generally contraindicated in the perinatal period. A large percentage of prescriptions were antibiotics classified as category B by the FDA. The most common infections that occurred in the perinatal period were those of the kidney and urinary tract in a higher number than in other studies. Conclusions: Our study shows that many classes of antibiotics used in perinatal women belong to category B antibiotics, the most prescribed being cephalosporins. Because of insufficient safety evidence and the potential for teratogenic effects on the fetus, restricted use among the category C and D antibiotic classes was seen and anticipated. Improving maternal health requires the involvement of healthcare experts in risk assessment and evaluation of existing data for appropriate antibiotic selection, dose, duration of medication, and monitoring.

700 Use of Antibiograms and Changes in Bacterial Resistance Patterns

IntroductionInfection is a leading cause of death in burn patients. With an increase in resistance patterns, management of these infections has become progressively difficult. Antibiograms, a summary of susceptibilities to bacteria in a given institution or area, are often used to guide empiric treatment of infections. However, inappropriate prescribing and use of empiric antimicrobials may greatly impact the incidence of resistance. Currently, we do not know the patterns of antibiotic use since the introduction of institutional antibiograms or associated changes in antibiotic resistance. The objective of this study is to describe trends in antibiotic susceptibilities in burn patients in Canada pre- (PrA) and post-introduction (PoA) of antibiograms.MethodsWe performed a retrospective review of patients admitted to an ABA-verified Burn Centre 2 years pre- (2013-2014) and post-introduction (2016-2017) of institutional antibiograms and started on broad-spectrum antibiotics (meropenem, piperacillin-tazobactam, and/or vancomycin).ResultsA total of 864 patients were admitted during the study period (n=420 PrA and n=444 PoA). Average age, % total body surface area (%TBSA), and length of stay were similar between cohorts. Administration of empiric meropenem increased (43.2% vs. 56.8%) and piperacillin-tazobactam decreased (60.6% vs. 39.4%), which was significant (p=0.002). The use of vancomycin was unchanged. There was a significant decrease in the overall use of empiric antibiotics (p=0.002) since the inception of antibiograms, with a significant improvement in culture and sensitivity (C&S) testing within 5 days of starting empiric antibiotics (p=0.002). There was no significant difference in use of targeted antibiotics pre- or post-antibiogram introduction.ConclusionsOur study demonstrates that since the inception of antibiograms, there has been a significant decrease in overall use of empiric antibiotics and improvement in acquiring C&S within 5 days. However, these antibiotics were not always targeted to the appropriate organism and therefore may contribute to multi-drug resistant organisms in a burn population.

Trends and Pattern of Antibiotic Use in Children in Northern Spain, Interpreting Data about Antibiotic Consumption in Pediatric Outpatients.

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 100,000 children up to 14 years old) from 2005 to 2018 were analyzed and compared with antibiotic consumption in general population in Spain. The pattern of use was analyzed 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 the pediatric population.

Overview of Antibiotic Use Patterns in Typhoid Fever Patients at the Toto Kabila Hospital Inpatient Unit in 2019

Typhoid fever is an acute systemic infectious disease caused by Salmonella typhi. Indonesia has a fairly high incidence with an increasing number of cases. It is estimated that there are 600,000 and 1.5 million cases of typhoid fever per year. Antibiotics are the main therapy for the treatment of typhoid fever patients. This study aims to describe the pattern of antibiotic use in typhoid fever patients in the inpatient installation of Toto Kabila Hospital in 2019.
 The method in this study uses descriptive statistics with the type of observational research. Data collection was carried out retrospectively. The sample was taken from the medical records of adult patients with typhoid fever who were treated at the Toto Kabila Hospital in 2019. The subject selection technique used random sampling. The subjects in this study were adult patients with typhoid fever who were treated at the Toto Kabila Hospital in 2019. The total sample obtained was 44 typhoid fever patients.
 The results showed that the class of antibiotics used was a third generation cephalosporin (84.1%) of the type of antibiotic ceftriaxone (72.7%) with a dose of 1 gram (72.7%) twice a day and given for 10-14 days. It can be concluded that the pattern of antibiotic use at the Toto Kabila Hospital, Gorontalo Province in 2019 was in accordance with the disease suffered.

Patterns of antibiotic use, knowledge, and perceptions among different population categories: A comprehensive study based in Arabic countries

BackgroundAntibiotics are essential for the treatment of bacterial infections and are considered among the most commonly sold drug classes from the community pharmacy in the developing countries without a prescription in most cases. PurposeThis study aims to explore the knowledge, practices, and attitudes regarding antibiotic use. Materials and methodsThis study employs a cross-sectional descriptive design that used a pre-validated survey. The participants were classified into three main mutually exclusive groups: healthcare professionals, medical students, and other adults in the community. ResultsOf the 10,226 participants, 1157 (11%) were healthcare professionals; 2322 (23%) were medical students and 6747 (66%) were other adults in community. The majority of participants used antibiotic at least once during the past year. A total of 838 (72.4%) healthcare professionals and 800 (34.5%) medical students had prescribed an antibiotic during the last 6 months.Almost half of the medical students and adults in the community and almost one-third of healthcare professionals reported that the aim of antibiotics use is for fever. Furthermore, around one-quarter of participants reported that the aim of antibiotics use is for viral infection. Around one-quarter of respondents stated that the antibiotic will always be effective in the treatment of the same infection in the future. Around one-quarter of participants stated that 21 to 50% of antibiotics are considered to be unnecessary or inappropriate prescriptions. Different factors were perceived as being very important causes of antibiotic resistance among the participants. ConclusionsThese findings indicated that this study participants showed unsatisfactory knowledge and perceptions of proper antibiotic use. Therefore, there is a requirement for a comprehensive and effective antibiotic-stewardship program to promote rational antibiotics use, and compensate for knowledge and perceptions gaps to prevent antibiotic resistance development.

Has the COVID-19 pandemic wiped out the seasonality of outpatient antibiotic use and influenza activity? A time-series analysis from 2014 to 2021

ObjectiveTo assess the influence of the emergence of severe acute respiratory syndrome coronavirus 2 and the implementation of public health measures on the seasonality of outpatient antibiotic use and their possible association with the incidence of influenza. MethodsWe performed a time-series ecological study in 1516 primary care centres of Andalusia, Spain, comparing the coronavirus disease 2019 period (April 2020 to March 2021) with the 6 previous years. We assessed the number of packs and defined daily doses per 1000 inhabitants of antibacterials and key antibiotics commonly used for acute respiratory tract infections and the number of influenza-positive cases per 100 000 inhabitants. We calculated the correlation between variables and analyzed the seasonal patterns and differences in quarterly antibiotic use. ResultsFor all quarters, a significant correlation was observed between influenza activity and antibiotic use (Spearman's r = 0.94; p < 0.001). Before the pandemic period, both variables presented similar seasonal patterns. After the start of the pandemic, influenza activity was suppressed and the pattern of antibiotic use flattened into a straight line (R2 = 0.96; p = 0.022) with a quarterly change of 3.9% (p = 0.007). Total antibiotic use and antibiotics used for treating acute respiratory tract infections showed significant reductions in all quarters compared to the previous year (p < 0.01). DiscussionThe coronavirus disease 2019 pandemic has strongly influenced the seasonality of antibiotic use in primary care. The decline in respiratory viruses, among which the influenza virus is a major player that may act as a proxy for general prevalence, is proposed as a reason for the flattening of the seasonal fluctuations of outpatient antibiotic use in our region.

Impact of a pilot multimodal intervention to decrease antibiotic use for respiratory infections in a geriatric clinic.

More than 80% of antibiotics are prescribed in the outpatient setting, of which 30% are inappropriate. The National Action Plan for Combating Antimicrobial Resistance called for a 50% decrease in outpatient antibiotic use by 2020. Inappropriate antibiotics are associated with adverse reactions and Clostridioides difficile infection, especially among older adults. Before and after study. We performed a quality improvement initiative at the University of Colorado Seniors Clinic. Providers received education on antibiotic guidelines, electronic antibiotic order sets were introduced with standardized stop dates. Antibiotic use data were collected for 6 months before and 6 months after the intervention, from December to May to avoid seasonal variation. Descriptive statistics and linear mixed-effects regression models were used for this comparison. Total antibiotic prescriptions for acute respiratory conditions decreased from 137 prescriptions before the intervention (December 1, 2017, to May 31, 2018) to 112 prescriptions after the intervention (December 1, 2018, to May 31, 2019), driven primarily by decreases in antibiotic prescriptions for pneumonia, sinusitis, and bronchitis. Prescriptions for broad-spectrum antibiotics declined following the intervention including decreases in levofloxacin from 12 (9%) to 3 (3%) and amoxicillin-clavulanate from 15 (12%) to 7 (7%). We detected significant reductions in prescribed antibiotic durations (days) after the intervention for sinusitis (estimate, -2.0; 95% CI, -3.1 to -1.0; P = .0003), pharyngitis (estimate, -2.5; 95% CI, -4.6 to -0.5; P = .018), and otitis (-3.2; 95% CI, -5.2 to -1.3; P = .008). Low-cost interventions were initially successful in changing patterns of antibiotic use and decreasing overall antibiotic prescribing among older patients in the outpatient setting. Long-term follow-up studies are needed to determine the sustainability and clinical impact of these interventions.

THE INFORMATION ON STATUS OF ANTIBIOTIC RESISTANCE CHANGING THE PERCEPTION AND ATTITUDES OF WISELY ANTIBIOTIC USE IN BANYUMAS DISTRICT COMMUNITIES

The wise use of antibiotics in the Banyumas community is quite alarming. Most of them still buy antibiotics without a doctor's prescription, buy half a prescription and consume antibiotics without finishing it. Good enough knowledge about the dangers of using antibiotics unwisely has not formed a correct perception and attittude of antibiotic use. This study aims to evaluate changes in people's perceptions and attitudes about antibiotic use after being given information related to their resistance status . This research was conducted qualitatively on 10 informants. Retrieval of data through focus group discussion techniques is done before and after providing resistance status information. The results showed that before giving information, perceptions and attitudes towards the use of antibiotics most (80%) of informants were not correct despite having a good level of knowledge. Changes in perceptions and attitudes about the right pattern of antibiotic use wisely occur after being given information about the status of antibiotic resistance they experience. This study can be concluded that the provision of information on the results of the examination of resistance status has a positive effect causing the changing in perception and the right attitude regarding the use of antibiotics wisely in the Banyumas community

PENGARUH RASIONALITAS PENGGUNAAN ANTIBIOTIK TERHADAP PROGRAM PENGGUNAAN OBAT RASIONAL (POR) DI PUSKESMAS SAMBI REJO KABUPATEN LANGKAT TAHUN 2020

Background: Rational drug selection is the key to quality health services. Improper use of antibiotics is one of the irrational uses of drugs and causes various health problems such as bacterial resistance and economic and social impacts. This study aimed to determine the pattern of antibiotic use against indicators of rational drug use in Sambi Rejo Public Health Center, Langkat Regency. Methods: The research method was carried out descriptively by retrospective data collection. Data on the use of antibiotics for the indicator of rational drug use is obtainable from the Rational Drug Use report data for the period January - December 2020, while data on pharmaceutical services was obtained in January - February 2021. The results of the study: The results showed that the use of antibiotics for indicators of rational drug use was Respiratory Tract Infection. The number of non-pneumonia was 28.33%, non-specific diarrhea was 46, 17 and the mean of drug items per prescription was 3.75 drug items. The results of research with in-depth interviews, participant observation and documentation study show that pharmaceutical services at the Sambi Rejo Health Center have been running quite well. The study concluded that pharmaceutical services at the Sambi Rejo Health Center have been running quite well, while the implementation of the rational drug use program at the Sambi Rejo Health Center has not been going well with the high use of antibiotics against indicators of rational drug use set by WHO.

Outpatient Antibiotic Prescribing Patterns and Appropriateness for Children in Primary Healthcare Settings in Beijing City, China, 2017–2019

(1) Background: Few studies have focused on antibiotic use and appropriateness in children in primary health institutions (PHIs). This study aimed to identify the patterns and appropriateness of antibiotic use for children in PHIs in Beijing, China. (2) Methods: Outpatient prescriptions of 327 PHIs from 2017 to 2019 for patients <18 years old were collected. Prescriptions were described using quantity indicators. Antibiotics were categorized according to ATC classification J01 and Access, Watch, Reserve grouping. Appropriateness was reviewed by experts using three subtypes of irrational prescriptions (irregular, inappropriate, and abnormal). (3) Results: 20,618 prescriptions were collected in total. The antibiotic prescription rate (APR) was 15.1% (N = 3113). Among antibiotic prescriptions, J01FA Macrolides were the most used (N = 1068, 34.9%). The Watch group constituted 89.0% (N = 2818) of total antibiotic use. Bronchitis (N = 1059, 35.2%) was the most common diagnosis. A total of 292 instances of irrational antibiotic use were identified, with inappropriate prescriptions being the most prevalent subtype (N = 233, 79.8%). (4) Conclusion: Although APR for children in PHIs in Beijing was relatively low, the pattern of antibiotic use differed from other countries. Further studies are needed to optimize antibiotic use for children in PHIs under different levels of economic development.

Long-term Antibiotic Treatment in Pouchitis-Patterns of Use and Safety.

Pouchitis, often developing after colectomy and ileal pouch-anal anastomosis for ulcerative colitis, is highly responsive to antibiotics. Ciprofloxacin and/or metronidazole are commonly used, often for prolonged periods. We report patterns of antibiotic use, adverse events, and resistant infections in patients with pouchitis with long-term antibiotic treatment. In a cohort of patients following pouch surgery, a retrospective nested case-control analysis was performed between 2010 and 2017. Ultra-long-term use, defined as the top 10% of users, was compared with the remaining users. Patterns of antibiotic use, adverse events, and resistant infections were analyzed. The cohort included 205 patients with UC, of whom 167 (81.5%) used antibiotics for pouchitis, predominantly ciprofloxacin. The long-term antibiotic use rate was 18% and 42% at 5 and 20 years postsurgery, respectively. Mean antibiotic use of at least 1, 3, and 6 months/year was noted in 54 (26.3%), 31 (15.1%), and 14 (6.8%) patients, respectively. Twenty-two (13.2%) and 4 (2.4%) patients reported mild and severe (transient) adverse events, respectively, without mortalities, tendinopathies or arrhythmias. Adverse event rates for ciprofloxacin and metronidazole were 1per 10,000 and 6 per 10,000 use-days, respectively. Longer, but not ultra-long antibiotic use, was associated with mild adverse events. There was no association between antibiotic use and resistant infections. Thirteen (6.3%) patients required ileostomy procedures-more commonly in the ultra-long-term antibiotic users. Patients with pouchitis may require prolonged antibiotic treatment, reflecting clinical benefit and favorable safety profile. Few adverse events and resistant infections were observed with long-term antibiotics use. However, resistant microbial strains selection, which are potentially transmittable, warrants consideration of different therapeutic alternatives.

Variation in antibiotic use among neonatal intensive care units in the United States.

Antibiotics are widely used in neonatal intensive care units (NICUs). We conducted a cross-sectional analysis of antibiotic use across US NICUs to evaluate overall, broad-spectrum, and combination antibiotic use. Patterns of antibiotic use varied by medical versus surgical service line, hospital, and geographic location.

Point prevalence of healthcare-associated infections and antibiotic use in a tertiary care teaching hospital in Nepal: A cross-sectional study.

Information on the burden of healthcare-associated infections (HAIs) and patterns of antibiotic use are prerequisites for infection prevention and control (IPC) and antibiotics stewardship programmes. However, a few studies have been reported from resource-limited settings and many of them have not used standard definitions to diagnose HAI precluding benchmarking with regional or international data. This study aims to estimate the prevalence of HAIs and antibiotic use in our centre. We conducted a point prevalence survey in a 350-bed university hospital in Kathmandu, Nepal in April 2019. We reviewed all patients aged ⩾ 18 years admitted to the hospital for at least two calendar days and evaluated for the three common HAIs-pneumonia, urinary tract infection and surgical site infection. We used the clinical criteria by the European Center for Disease Prevention and Control to diagnose the HAIs. We also collected information on the antibiotics used. Of 160 eligible patients, 18 (11.25%) had HAIs and 114 (87.5%) were on antibiotics, with more than half of them (61/114 patients, 53.5%) receiving two or more antibiotics. This highlights the need for effective implementation of IPC as well as antibiotics stewardship programmes in our centre.

Antibiotic use and irrational antibiotic prescriptions in 66 primary healthcare institutions in Beijing City, China, 2015\u20132018

ObjectivesTo identify the patterns of antibiotic use and irrational antibiotic prescriptions in primary healthcare institutions (PHIs) in Dongcheng District of Beijing, China.Materials and methodsAll primary healthcare institutions (7 community healthcare centres and 59 community healthcare stations in total) in Dongcheng District were included in the study. Prescription data from January 2015 to December 2018 was derived from the Beijing Prescription Reviewing System of Primary healthcare institutions and analysed retrospectively. The antibiotic prescription rate was calculated and cases of irrational antibiotic prescriptions were identified.ResultsWe extracted 11,166,905 prescriptions from the database. Only 189,962 prescriptions were included in the study, among which 9167 (4.8%) contained antibiotics. The antibiotic prescription rate fell from 5.2% in 2015 to 4.1% in 2018 while irrational antibiotic prescription rate increased from 10.4 to 11.8%. Acute Bronchitis was the most prevalent diagnosis (17.6%) for antibiotic prescriptions, followed by Unspecified Acute Respiratory Tract Infection (14.4%), Acute Tonsillitis (9.9%), and Urinary Tract Infection (6.4%). Around 10% of the prescriptions for the top 7 diagnoses identified were rated as irrational. Cephalosporins, fluoroquinolones, and macrolides were the most prescribed antibiotics, which accounted for 89.3% of all antibiotic prescriptions. Of all the antibiotic prescriptions, 7531 were reviewed, among which 939 (12.5%) were rated as irrational because of antibiotic use. Among all the irrational prescriptions, prescriptions with inappropriate antibiotic use and dosage accounted for the majority (54.4%).ConclusionAlthough a relatively low level of antibiotic utilization was found in PHIs in Dongcheng District of Beijing, the utilization patterns differed considerably from developed countries and irrational prescriptions remained. Considering the imbalanced allocation of medical resources between primary healthcare setting and secondary and tertiary hospitals, there need to be more efforts invested in regions with different levels of economic development.

Studi Rasionalitas Penggunaan Antibiotika di RSUD DR. Murjani Sampit

Background Antibiotics are the most widely used type of drug due to the high incidence of infection in Indonesia. From the results of the preliminary study for 3 days prospectively, as many as 44 patients who received treatment, 37 patients (87%) received antibiotic therapy. There is the use of expensive antibiotics from the 3rd generation cephalosporin group, there are 4 trade names, 2 generation cephalosporins and 1 there are 6 trade names. Expensive sulbenicin and aminoglycoside derivatives are also found, Gentamicin and Kanamycin. The relatively cheap antibiotics are chloramphenicol, tetracycline, cotrimoxazole, but various brands of these products are popular with "me too drug" being used, of course with varying prices. Government Hospital type C should refer to the use of generic drugs and refer to the national antibiotic use guidelines. Therefore, researchers want to investigate further.&#x0D; Objective To study the patterns of antibiotic use at the Dr Murjani Sampit Regional Hospital before and after the Educational Information Communication on Guidelines for the Use of National Antibiotics.&#x0D; Method This study used a retospective and prospective descriptive observational study with pre-research intervention to medical personnel on the Guidelines for the Use of National Antibiotics and Rational Pharmacotherapy, to paramedics on the stability and method of administering injection dosage antibiotics. This retrospective study used medical documents for patients at 3 months intervals from inpatients for Surgery, Internal Medicine, Children and Gynecology. Prospective study of inpatients at the UPF Surgery, Internal Medicine, Children, and Gynecology for 1 week. Analysis of antibiotic prescribing patterns and the rationality of using antibiotics based on the National Antibiotic Guidelines and Use references. &#x0D; Results The distribution pattern of antibiotic use from a retrospective study of 447 patients, there were 260 (58.1%) patients using antibiotics. Even in obstetrics UPF, 100% of the gynecologists used antibiotics. The results of a retrospective study on the rational category and the cost of using antibiotics found the rationality of the indications and patients only reached &lt;50% of the 4 UPFs studied. The rationality of the dosage regimen was &lt;20% and the dose regimen &lt;10%. Average cost of antibiotics wasted Rp. 80,374 per patient. The highest wastage was at UPF Obstetrics and Gynecology of Rp. 145,223/patient, while the lowest was in UPF Children of Rp. 40,837,-/ patient. From the prospective study, there were 260 patients, 100% used antibiotics with the rationality of the indications and the patients &lt;50%, the rationality of the drug selection was &lt;20%, the rationality of the dosage regimen was &lt;10%. The average wasted cost of antibiotics which became a burden for patients was Rp. 74,793,-/patient with the highest waste at the UPF Gynecology Rp. 119,272,-/patient and the lowest in UPF Children was Rp. 34,697,-/patient.&#x0D; Conclusion The pattern of antibiotic use in Dr Murjani Sampit Hospital in the 4 UPFs studied was 49.1 - 100%. There was an irrational use of antibiotics, the right indication was &lt;43%, the right drug selection was &lt;37.7%, the right dose regimen was &lt;20.8%, there was a combination of antibiotic interactions &lt;6.9% and there was a waste from the use of antibiotics Rp. 80,374,-/patient in retrospective and Rp. 74,793,-/patient in the prospective study.&#x0D; Keywords Rationality, Antibiotics