Short-term effect of antibiotic control policy on the usage patterns and cost of antimicrobials, mortality, nosocomial infection rates and antibacterial resistance.
OBJECTIVE
In 2003 Turkish government released a new budget application instruction for regulating the usage of parenteral antibiotics inside and outside of the hospitals. In this study it was aimed to evaluate the effect of this instruction on the overall usage of restricted antibiotics, their cost, overall mortality, bacterial resistance patterns and nosocomial infection rates in intensive care units (ICUs) of our setting for March-October 2002 and March-October 2003 periods.


RESULTS
Overall daily defined dose/1000 patients/day of restricted drugs decreased, whereas unrestricted drugs increased significantly after the instruction. The cost of all analysed drugs in 2003 period was 540,303USD (-19.6%) less than 2002 period. Nosocomial infection rates in ICUs decreased significantly (p<0.05). When all microbiologically confirmed nosocomial bacteremia cases during the study period were analysed, amoxycilline/clavulanate, ciprofloxacin, cefuroxime, cefotaxime, piperacilline/tazobactam resistance and ESBL rate in Klebsiella pneumoniae decreased significantly (p<0.05). Amikacin resistance in Escherichia coli and Acinetobacter baumannii increased significantly (p<0.05).


CONCLUSIONS
Antibiotic control is one of the most important and significant ways to save money, and to prevent antibacterial resistance.
Arda
Bilgin
B
Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Bornova, Izmir, Turkey.
Sipahi
Oguz Resat
OR
Yamazhan
Tansu
T
Tasbakan
Meltem
M
Pullukcu
Husnu
H
Tunger
Alper
A
Buke
Cagri
C
Ulusoy
Sercan
S
D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D016470:Bacteremia / Q000453:epidemiology / Q000401:mortality; D001424:Bacterial Infections / Q000453:epidemiology / Q000401:mortality; D003428:Cross Infection / Q000453:epidemiology* / Q000401:mortality*; D004352:Drug Resistance, Microbial; D017723:Drug Utilization Review / Q000191:economics* / Q000379:methods*; D004469:Economics, Hospital; D006291:Health Policy; D006801:Humans; D007362:Intensive Care Units; D015996:Survival Rate; D013997:Time Factors; D014421:Turkey
D000900:Anti-Bacterial Agents