title: Drug utilization 75% (DU75%) in 17 European hospitals (2000-2005): results from the ESAC-2 Hospital Care Sub Project.
abstract: The study aimed to assess 75% of drug utilization (DU75%) in participating hospitals and identify quality indicators which should be used to monitor performance within the hospitals. In the European Surveillance of Antimicrobial Consumption (ESAC; http://www.esac.ua.ac.be) project anatomic therapeutic chemical (ATC), defined daily dose (DDD) and route of administration (RoA) were used for drug categorization. Data were collected for: antibacterials for systemic use; intestinal antibiotics; rifampicin; and nitroimidazole derivatives. Each hospital's annual data were analyzed separately (hospital-year) adding up to a total of 97 hospital-year data-sets. The drug most persistently present within DU75% was ciprofloxacin (84/97 hospital-years). Co-amoxiclav was the drug which most frequently ranked first (28 times). The number of drugs constituting the DU75% by substance ranged from 7-15 (median 12) and 8-19 (median 15) by RoA which identified oral amoxicillin most frequently ranking first (17 times). In many hospitals the oral route accounted for most of the DU75%. Therefore, the extent of oral use was identified as a quality indicator which could be monitored using DU75% methodology. Since substantial variation both in extent and distribution of antibiotic use was observed, DU75% methodology is best adapted for intra-hospital consumption trend analyses or for hospitals with comparable characteristics and formularies. The number of drugs within DU75% was identified as another quality indicator. Thus, aspiring to decrease the consumption of overused drug classes should be set by the hospitals as a quality indicator on prescribing patterns.
authors.affiliation: European Surveillance of Antimicrobial Consumption, University of Antwerp, Vaccine and Infectious Disease Institute, Antwerp, Belgium. peter.zarb@ua.ac.be
authors.forename: Peter
authors.initials: P
authors.lastname: Zarb
authors.forename: Faranak
authors.initials: F
authors.lastname: Ansari
authors.forename: Arno
authors.initials: A
authors.lastname: Muller
authors.forename: Venessa
authors.initials: V
authors.lastname: Vankerckhoven
authors.forename: Peter G
authors.initials: PG
authors.lastname: Davey
authors.forename: Herman
authors.initials: H
authors.lastname: Goossens
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003625:Data Collection; D004363:Drug Utilization / Q000706:statistics & numerical data; D005060:Europe; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents