Quality use of medicines: a new method of combining antibiotic consumption and sensitivity data--application in a Russian hospital.
OBJECTIVE
Antibiotic use and resistance is subject of great concern. There is a need for internationally comparable and locally useful data collection and reporting. We developed a new method to combine and present data on antibiotic use and resistance in a figure in a Russian 1300 bed-hospital.


METHODS
We applied World Health Organization (WHO) Anatomic Therapeutic Chemical (ATC) classification/defined daily doses (DDD) analysis on antibacterials for systemic use (ATC: J01) delivered by the pharmacy for the years 2003-2005. Microbial resistance data were presented within the range of drugs accounting for 90% of the volume in DDD, i.e. drug utilisation 90% (DU90%).


RESULTS
From the DU90% profile the following was seen: in 2003, 12 of 25 drugs accounted for 90% of the volume. For six of the most commonly used antibiotics, including the two cheapest (gentamicin, ampicillin), a significant number of the strains tested were resistant. For the remaining antibiotics no resistance data were available. These data were discussed in early 2004. A general decrease of antibiotic use and resistance was seen in 2005 (by 57% from 15.5 to 8.8 DDD/100 bed days) with a concomitant decrease in expenditures (by 64%) and a shift to more potent antibiotics.


CONCLUSIONS
The created profile highlighted potential problems in a clear and easy form. Besides being an indicator of the quality of antibiotic use it was a powerful alert and driving force for change. It can be used for external comparisons and for local monitoring of antibiotic use and resistance and can be applied with routinely available data in any hospital.
Goryachkina
Ksenia
K
Course of Clinical Pharmacology, Department of Hospital Therapy, St Petersburg State Medical Academy named after I.I.Mechnikov, Russia.
Babak
Svetlana
S
Burbello
Aleksandra
A
Wettemark
Björn
B
Bergman
Ulf
U
D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D003625:Data Collection / Q000379:methods*; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization / Q000592:standards; D006746:Hospital Bed Capacity, 500 and over; D006785:Hospitals, University; D006801:Humans; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D012426:Russia
D000900:Anti-Bacterial Agents