Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study

Nunes, Patricia Helena Castro; Moreira, Jacqueline de Oliveira; Thompson, Alessandra de Figueiredo; Machado, Thalita Lyrio da Silveira; Cerbino-Neto, José; Bozza, Fernando A.

doi:10.3389/fphar.2022.913568

Cited by 5 publications

(3 citation statements)

References 27 publications

(35 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9 Therefore, the potential application of PDD-based metrics should be examined by utilizing more detailed data, such as electronic health records, in further studies including patients and populations that reported large deviations between PDD and DDD. 19 This study had several limitations. First, these metrics cannot be applied to children in other countries because the PDDs indicate the dose prescribed for pediatric patients in Japan.…”

Section: Discussionmentioning

confidence: 93%

“…To deal with body weight variations, some studies have utilized PDDs as PDD (mg/kg/day) or have combined PDD (mg/day) with body weight stratification. [17][18][19][20] PDDs are flexible and helpful metrics, even with weight variations similar to those in the child population. However, this metric must be developed in each country because of differences in indications or recommendations.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Prescribed daily-dose–based metrics of oral antibiotic use for hospitalized children in Japan

Mimura

Shinjo

Shoji

et al. 2023

ASHE

View full text Add to dashboard Cite

Objective: Defined daily-dose (DDD)–based metrics are frequently used to measure antibiotic consumption. However, they are unsuitable for the pediatric population because they are defined using the maintenance dose for 70-kg adults. Moreover, children have large body weight variations. We assessed the prescribed daily dose (PDD) and PDD-based metrics of oral antibiotics for children to develop an alternative to DDD-based metrics in Japan. Design: We performed observational study using data from the Japanese administrative claims database between April 2018 and March 2019. Methods: Of 453,001 patients (aged 1 month–15 years), 564,326 admissions to 1,159 hospitals were included. We showed the median PDD (mg/day and mg/kg/day) and PDD-based metrics for 8 antibiotics for each age category (1 month to <1 year old and 1–6, 7–12, and 13–15 years old). We also assessed the relationship between PDD-based metrics and days of therapy (DOT)–based metrics using a scatter plot and correlation. Results: In total, 86,389 patients (19.1%) were prescribed oral antibiotics; amoxicillin, macrolides, and third-generation cephalosporins were the most common. The PDD (mg/day) for each antibiotic increased with age to 7–12 years old, when an adult dose was reached. The PDD (mg/kg/day) decreased with age to 13–15 years old, due to increasing body weight. The relationship between PDD per 1,000 patient days and DOT per 1,000 patient days differed depending on the antibiotic. Conclusions: PDD-based metrics stratified by age could characterize antibiotic consumption, even with body-weight variations. Therefore, PDD-based metrics, in addition to DOT-based metrics, are helpful benchmarks for antibiotic use in children.

show abstract

Section: Discussionmentioning

confidence: 93%

mentioning

confidence: 99%

Prescribed daily-dose–based metrics of oral antibiotic use for hospitalized children in Japan

Mimura

Shinjo

Shoji

et al. 2023

ASHE

View full text Add to dashboard Cite

show abstract

“…The quality of antibiotic use was evaluated to see the accuracy of the use of antibiotics with the Gyssens method with category 0 (appropriate and rational use of antibiotics), category I (incorrect timing of antibiotic administration), category II (inappropriate dose, route and interval of antibiotic administration), category III (inappropriate duration of antibiotic administration), category IV (inappropriate choice of antibiotics), category V (no indication of antibiotic administration), and category VI (incomplete data so antibiotic use cannot be assessed) [8]. The quantity of antibiotic use was calculated based on the DDD method/100 patient-days of hospitalization [9]. In evaluating the use of antibiotics quantitatively, the WHO has established the ATC/DDD system as an international measurement standard.…”

Section: Methodsmentioning

confidence: 99%

Untitled

2024

J. Med. Chem. Sci.

View full text Add to dashboard Cite

Background: High use of antibiotics in sepsis patients can lead to irrational use of antibiotics. Irrational antibiotic therapy in septic patients in the ICU increases the mortality rate in the hospital. Efforts to maximize the rational use of antibiotics are one of the pharmacist's responsibilities. Aim: This study aims to evaluate the quality and quantity of antibiotic use in sepsis patients in the Intensive Care Unit (ICU) ward using the Gyssens and ATC/DDD methods and to evaluate the effect of pharmacist intervention in improving the quality of antibiotic use and therapeutic outcomes. Materials and methods:The research was carried out prospectively during the period of August-November 2018 using a one-group pretestposttest pre-experimental study design. Recommendations are given to prescribers regarding the problem of inappropriate use of antibiotics. Result: Qualitative evaluation using the Gyssens method found that rational use of antibiotics in sepsis patients was 85.1% and 14.9% were irrational. The interventions increased the accuracy of the use of antibiotics (0% to 64.7%), reduced the problem of choosing antibiotics (88.2% to 32.4%), the problem of the duration of antibiotic administration (5.9% to 0%) and the problem of the route of administration of antibiotics (5.9% to 0%). The results of the quantitative evaluation obtained the value of the use of antibiotics, namely 63.8 DDD/100 days of treatment, with the greatest value for meropenem antibiotics, namely 32.9 DDD/100 days of treatment. Conclusion: There are differences in the therapeutic results between the quality of rational use of antibiotics and the quality of irrational use of antibiotics in the ICU ward of Fatmawati Hospital.

show abstract

Hospital prescribing patterns of antibiotics in Zambia using the WHO prescribing indicators post-COVID-19 pandemic: findings and implications

Mudenda,

Chilimboyi,

Matafwali

et al. 2023

JAC-Antimicrobial Resistance

View full text Add to dashboard Cite

Background Antimicrobial resistance (AMR) is a global public health problem that is fuelled by the inappropriate prescribing of antibiotics, especially those from the ‘watch’ and ‘reserve’ antibiotic lists. The irrational prescribing of antibiotics is particularly prevalent in developing countries, including Zambia. Consequently, there is a need to better understand prescribing patterns across sectors in Zambia as a basis for future interventions. This study evaluated the prescribing patterns of antibiotics using the WHO prescribing indicators alongside the ‘access, watch and reserve’ (AWaRe) classification system post-COVID pandemic at a faith-based hospital in Zambia. Methods A cross-sectional study was conducted from August 2023 to October 2023 involving the review of medical records at St. Francis’ Mission Hospital in Zambia. A WHO-validated tool was used to evaluate antibiotic prescribing patterns alongside the AWaRe classification tool. Results Out of 800 medical records reviewed, 2003 medicines were prescribed. Each patient received an average of 2.5 medicines per prescription. Antibiotics were prescribed in 72.3% of encounters, of which 28.4% were injectable. The most frequently prescribed antibiotics were amoxicillin (23.4%—access), metronidazole (17.1%—access), ciprofloxacin (8%—watch) and ceftriaxone (7.4%—watch), with 77.1% overall from the ‘access’ list. Encouragingly, 96.5% of the medicines were prescribed by their generic names and 98% were from the Zambia Essential Medicines List. Conclusions There were high rates of antibiotic prescribing, including injectable antibiotics, which needs addressing going forward. It is crucial to implement targeted measures, including antimicrobial stewardship programmes, to improve future antibiotic prescribing in Zambia and reduce the risk of AMR.

show abstract

Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study

Cited by 5 publications

References 27 publications

Prescribed daily-dose–based metrics of oral antibiotic use for hospitalized children in Japan

Prescribed daily-dose–based metrics of oral antibiotic use for hospitalized children in Japan

Untitled

Hospital prescribing patterns of antibiotics in Zambia using the WHO prescribing indicators post-COVID-19 pandemic: findings and implications

Contact Info

Product

Resources

About