title: Variations and determinants of antibiotic consumption in Hungarian adult intensive care units.
abstract: OBJECTIVE
  The aim of this work was to study the use of systemic antibacterials and its possible determinants in Hungarian intensive care units (ICUs).
  
  
  METHODS
  Hospital pharmacy. departments provided package level dispensing data for their corresponding ICU (2006). Data were converted into defined daily doses (DDDs) and expressed as DDD per 100 patient-days and DDD per 100 admissions. Antibiotics were ranked by volume of DDDs, and the agents responsible for 90% of total use (DU90%) were noted. To explore differences and relationships between antibiotic use and antibiotic policy elements/ICU characteristics, the analysis of variances or the Pearson correlation analysis was performed.
  
  
  RESULTS
  Valid data were obtained for 44 ICUs. Antibiotic use varied widely (from 27.9 to 167.8 DDD per 100 patient-days and from 104.7 to 1784.6 DDD per 100 admissions). In total, 11-34 different antibacterials per ICUs were used, of which, 5-15 were in the DU90% segment. The proportional use of parenteral agents ranged from 46.2 to 98.3%. The mean of overall antibiotic use was highest for penicillins with beta-lactamase inhibitors, followed by quinolones and third-generation cephalosporins. Of the studied factors, only the ICU category (i.e., level of care) showed significant association with total antibacterial use.
  
  
  CONCLUSIONS
  The striking differences in total antibiotic use and the extensive use of the oral agents in some ICUs may indicate room for improvement. As none of the antibiotic policy elements were accompanied by lower antibiotic use in the pooled analysis, it suggests that--beside the ICU category--other unrevealed factors determine antibiotic use.
authors.affiliation: Department of Clinical Pharmacy, University of Szeged, Szeged, Hungary. benko@clph.szote.u-szeged.hu
authors.forename: Ria
authors.initials: R
authors.lastname: Benko
authors.forename: Mária
authors.initials: M
authors.lastname: Matuz
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Peto
authors.forename: Lajos
authors.initials: L
authors.lastname: Bogár
authors.forename: Réka
authors.initials: R
authors.lastname: Viola
authors.forename: Péter
authors.initials: P
authors.lastname: Doró
authors.forename: Gyöngyvér
authors.initials: G
authors.lastname: Soós
authors.forename: Edit
authors.initials: E
authors.lastname: Hajdú
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003422:Critical Care / Q000706:statistics & numerical data; D006801:Humans; D006814:Hungary; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D016134:Organizational Policy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data
chemical_list: D000900:Anti-Bacterial Agents