title: Analysis of antimicrobial consumption and cost in a teaching hospital.
abstract: BACKGROUND
  The aim of this study is to compare the periods before and after the intervention applied using the ATC/DDD method in order to ascertain the rational use of antibiotics in a newly established hospital.
  
  
  METHODS
  The appropriateness of the hospital's antibiotic use, consumption rates and the costs were calculated and compared with other hospitals. Based on these data, an intervention has been planned in order to raise the quality of antibiotic use. The periods before and after the intervention were compared. Between 16 May 2011 and 23 May 2012, data were collected from all hospital units by the infectious diseases specialists and a point prevalence survey was conducted. Anatomical therapeutic chemical classification and the defined daily dose (DDD) methodology were used to calculate the antibiotic consumption.
  
  
  RESULTS
  On two specific days in 2011 and 2012, 194 out of 307 patients (63.2%) and 224 out of 412 patients (54.4%) received antibiotic treatment, respectively. In 2011 and 2012, the percentage of appropriate antibiotic use was 51% and 64.3%, respectively. Both in 2011 and 2012, inappropriate antibiotic use was found to be significantly higher in surgical clinics in comparison to the internal diseases clinics and the ICU. This was caused by the high rates of inappropriate perioperative antimicrobial prophylaxis observed in surgical clinics. During both years, approximately one-third of the antibiotics were prescribed for the purposes of perioperative prophylaxis, while 88.5% and 43.7% of these, respectively, were inappropriate and unnecessary. Cephalosporins, fluoroquinolones, combinations of penicillins (including β-lactamase inhibitors) and carbapenems were the most frequently prescribed antibiotics during the study periods. The mean total antibiotic consumption was 93.6 DDD/100 bed-days and 63.1 DDD/100 bed-days, respectively. The cost of total antibacterial consumption was € 7901.33 for all the patients (€ 40.72 per infected patient) and € 6500.26 (€ 29.01 per infected patient), respectively.
  
  
  CONCLUSIONS
  Each hospital should follow and assess their antibiotic use expressed in DDD in order to compare their antibiotic use with national and international hospitals (WHO, 2009 [14]).
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. Electronic address: drfatmayakut@hotmail.com.
authors.forename: Fatma
authors.initials: F
authors.lastname: Bozkurt
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey.
authors.forename: Safak
authors.initials: S
authors.lastname: Kaya
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Tekin
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey.
authors.forename: Serda
authors.initials: S
authors.lastname: Gulsun
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
authors.forename: Ozcan
authors.initials: O
authors.lastname: Deveci
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
authors.forename: Saim
authors.initials: S
authors.lastname: Dayan
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
authors.forename: Salih
authors.initials: S
authors.lastname: Hoşoglu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000191:economics* / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic / Q000379:methods / Q000592:standards*; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents
keywords: ACI; Appropriateness; Cost; Surveillance