Antibiotic consumption in Turkish hospitals; a multi-centre point prevalence study

Abstract

This multi-centre study aimed to determine the antibiotic consumption in Turkish hospitals by point prevalence. Antibiotic consumption of 14 centres was determined using the DDD method. Among hospitalized patients, 44.8% were using antibiotics and the total antibiotic consumption was 674.5 DDD/1000 patient-days (DPD). 189.6 (28%) DPD of the antibiotic consumption was restricted while 484.9 (72%) DPD was unrestricted. Carbapenems (24%) and beta lactam/beta lactamase inhibitors (ampicillin-sulbactam or amoxicillin-clavulanate; 22%) were the most commonly used restricted and unrestricted antibiotics. Antibiotics were most commonly used in intensive care units (1307.7 DPD). Almost half of the hospitalized patients in our hospitals were using at least one antibiotic. Moreover, among these antibiotics, the most commonly used ones were carbapenems, quinolones and cephalosporins, which are known to cause collateral damage. We think that antibiotic resistance, which is seen at considerably high rates in our hospitals, is associated with this level of consumption.

High rate of colistin and fosfomycin resistance among carbapenemase-producing Enterobacteriaceae in Turkey

“…The reason behind such high rates of resistance is that only the XDR and MDR isolates were selected for this study. Moreover, a study on antibiotic consumption among patients, hospitalized in Turkey, showed that 44.8% of them were using antibiotics and the total antibiotic consumption was 674.5 defined daily dose/1000 patient-days [18]. Therefore, it is highly possible that a high rate of resistance is associated with antibiotic consumption.…”

Inapropriate Use of Antibiotics Effective Against Gram Positive Microorganisms Despite Restrictive Antibiotic Policies in ICUs: A Prospective Observational Study

“…In Turkey, 71.3% of patients in ICUs are treated with antibiotics [2]. This widespread use is unnecessary and inappropriate.…”

“…Keywords: Antibiotic stewardship, rational antibiotic use, antibiotic resistance, gram positive microorganisms, inappropriate antibiotic use Background Infection development is an important cause of morbidity and mortality in intensive care units (ICUs), leading to the widespread use of antibiotics [1]. {, #1@@hidden}{Kallen, 2018 #382}{, 2018 #382} {Kallen, 2018 #404}It is reported that 41-85% of ICU patients use at least one antibiotic and antibiotic consumption is 10 times higher in ICUs compared to other units [2]. This widespread usage increases the unnecessary and inappropriate use of antibiotics and causes an increase in antimicrobial resistance [3].…”

“…Antimicrobial resistance typically increases the risk of poor clinical outcomes and death in ICUs patients [3]. Approximately 20 -50% of hospitalized patients and 30-60% of patients in ICUs are prescribed unnecessary, inappropriate or sub-optimal antibiotic treatment [2][3][4][5]. Inappropriate use of empirical antibiotic treatments increases the frequency of early and late period mortality, length of hospital stay and healthcare-associated costs in ICU patients [4].…”

“…Gram-positive spectrum antibiotics such as vancomycin, teicoplanin, daptomycin ,and linezolid are frequently used in empirical treatment combinations in critically ill patients [10]. In Turkey, after betalactams and fluoroquinolones, these gram-positive antibiotics are reported to be the most commonly used antibiotics in ICUs [2]. Their widespread use, is thought to be not only inappropriate and unnecessary, but also responsible for sub-optimal utilisation.…”