Relationship between outpatient antibiotic use and the prevalence of bacterial infections in Montenegro

Sahman-Zaimovic, Majda; Vukmirović, Saša; Tomić, Nataša Z.; Stilinović, Nebojša; Horvat, Olga; Tomić, Ljiljana

doi:10.2298/vsp150626146s

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…40 However, nearly approachable result with study from Croatia (3.29 DDD/1000 inhabitants per day). 41 Unlike the study from Tanzania, 37 and Montenegro 38 where the penicillins, quinolones and tetracycline were consumed most frequently, in the current study tetracycline (doxycycline) was consumed most frequently (1.59 DDD/100 outpatients per day) followed by fluoroquinolones (1.48 DDD/100 outpatients per day) and penicillins (1.13 DDD/100 outpatients per day). This difference in volume of consumption may be related to short data collection period (two months) in the current study.…”

Section: Discussioncontrasting

confidence: 73%

“…The overall antibiotic consumption volume was 5.31 DDD/100 outpatients per day. This was lower than reports from other countries, such as Tanzania (4.99 DDD/1000 inhabitants per day), 37 Montenegro (39.05 DDD/1000 inhabitants/day), 38 Slovenia (59.8 DDD/1000 inhabitants per day), 39 and Syria (20.13 DDD/1000 inhabitants per day). 40 However, nearly approachable result with study from Croatia (3.29 DDD/1000 inhabitants per day).…”

Section: Discussioncontrasting

confidence: 57%

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Evaluation of Adult Outpatient Antibiotics Use at Jimma Medical Center (with Defined Daily Doses for Usage Metrics)

Melaku¹,

Gashaw²,

Chelkeba³

et al. 2021

IDR

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Introduction Inappropriate antibiotic use is a major public health concern and driver of antibiotic resistance. Excessive exposure to antibiotics results in the emergence and spread of drug-resistant microorganisms. This study aimed to measure the volume of antibiotic consumption at the outpatient settings in a tertiary-care teaching hospital in Ethiopia. Methods A cross-sectional study was undertaken from February 01, 2019 to March 31, 2019 at Jimma Medical Center in southwest Ethiopia. Antibiotics use was analyzed using Anatomical Therapeutic Chemical Classification and Defined Daily Dose (DDD) system. Antibiotic use was calculated as DDD per 100 outpatients per day. Antibiotics were classified based on World Health Organization “AWaRe” classification scheme as “Access”, “Watch” and “Reserve” group antibiotics and measured their consumption intensity. Results A total of 496 adult patients were included in the study. The mean (SD) age of participants was 33.07 (14.05) years. The total amount of antibiotics consumed was 5.31 DDD/100 outpatients per day. Ciprofloxacin was the most commonly [122 (21.12%)] prescribed antibiotics with DDD/100 outpatients per day value of 1.13, followed by amoxicillin [68 (11.76%)] with DDD/100 outpatients per day value of 0.44, and azithromycin [61 (10.55%)] with DDD/100 outpatients per day value of 0.51. On antibiotic consumption index, antibiotics in the “Watch” group had 2.10 DDD/100 outpatients per day. Conclusion There was high consumption of antibiotics in the study setting. Based on the use control criteria, half of the antibiotics used were in the “Watch” group. The high level of consumptions of antibiotics, such as ciprofloxacin, norfloxacin, and azithromycin, in particular, requires further scrutiny and calls for an urgent implementation of an antibiotic stewardship program at the hospital.

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Section: Discussioncontrasting

confidence: 73%

Section: Discussioncontrasting

confidence: 57%

Evaluation of Adult Outpatient Antibiotics Use at Jimma Medical Center (with Defined Daily Doses for Usage Metrics)

Melaku¹,

Gashaw²,

Chelkeba³

et al. 2021

IDR

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“…This may again be linked to an increased resistance to narrow-spectrum antibiotics. Šahman-Zaimović et al found that, in cases of high resistance to amoxicillin, amoxicillin/clavulanic acid is recommended [ 35 ]. The broad-spectrum antibiotic dispensing rates in this study are high.…”

Section: Discussionmentioning

confidence: 99%

Outpatient Antibiotic Dispensing for the Population with Government Health Insurance in Syria in 2018–2019

2020

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Little is known about antibiotic uses at the population level in Syria. The aim of our study is to present outpatient antibiotic dispensing (OAD) patterns and rates for patients with health insurance in the parts of Syria that are controlled by the Syrian government using different indicators. Outpatient data on all dispensed antibiotics for 81,314 adults with health insurance were obtained and stratified according to age, sex, governorate and annual season. OAD was mainly expressed as the number of defined daily doses (DDDs) per 1000 people per day (DID). OAD patterns were assessed according to the anatomical therapeutic classification (ATC) and the Access, Watch and Reserve (AWaRe) classification. OAD was 20.13 DID. Amoxicillin/clavulanic acid and clarithromycin were the most dispensed antibiotics (5.76 and 4.4 DID, respectively). Overall, a predominant consumption of broad-spectrum antibiotics was noted. The Watch group of the AWaRe classification had the biggest percentage of OAD (13.26 DID), followed by the Access and the Reserve groups (6.55 and 0.17 DID, respectively). There was a significant difference in OAD between the sex and age groups. The seasonal and regional variations in OAD were also significant. Broad-spectrum antibiotics dispensing was high compared to other studies from different countries. These results are concerning, as they can contribute to antibiotic resistance.

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“…It is widely known that antibiotic use and antibiotic resistance patterns are correlated [18–20] and surveillance data on country-level antibiotic use are needed to support policies that aim to reduce antibiotic resistance. Although several studies have attempted to assess antibiotic use in China [21–24], none has reported quarterly data and the influencing factors of inpatient antibiotic consumption.…”

Section: Introductionmentioning

confidence: 99%

Trends and Drivers of Inpatient Antibiotic Consumption among 89 China Tertiary General Hospitals from 2011Q1 to 2015Q4

Chen

Wang

et al. 2018

BioMed Research International

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Antibacterial surveillance is an essential measure for strengthening the management of clinical antibiotic use. This study aimed to determine the trends and drivers of inpatient antibiotic consumption in China. A sample of 89 hospitals with complete data from 2011Q1 to 2015Q4 was included. Accumulative defined daily doses (DDDs), antibiotic use density (AUD), and drug variety were calculated to evaluate antibiotic consumption. From 2011Q1 to 2015Q4, the median values of DDDs, AUD, and drug variety dropped by 10.49%, 39.19%, and 27.96%, respectively. Panel regression results showed, for each additional quarter, DDDs reduced by 6.714 DDDs, AUD reduced by 0.013 DDDs per 100 inpatients per day, and drug variety reduced by 0.012 types (p < 0.001). National hospitals were more likely to use antibiotics, with the highest number of DDDs (106 709 DDDs) and AUD (60 DDDs per 100 inpatients per day) and a large number of drug variety (71 types of drug) all reported from national hospitals. Overall, a downward trend of inpatient antibiotic consumption was observed in competitive tertiary general hospitals in China. However, antibiotic use in China, especially in national hospitals, continues to exceed the guidelines set forth by the nationwide antibiotic stewardship program. China must continue to improve surveillance of antibiotic consumption by constructing a more comprehensive, continuous, and targeted stewardship program. Policy interventions in China should be made in consideration of unbalanced regional development and the consequences this may have on antibiotic consumption.

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Relationship between outpatient antibiotic use and the prevalence of bacterial infections in Montenegro

Cited by 5 publications

References 8 publications

Evaluation of Adult Outpatient Antibiotics Use at Jimma Medical Center (with Defined Daily Doses for Usage Metrics)

Evaluation of Adult Outpatient Antibiotics Use at Jimma Medical Center (with Defined Daily Doses for Usage Metrics)

Outpatient Antibiotic Dispensing for the Population with Government Health Insurance in Syria in 2018–2019

Trends and Drivers of Inpatient Antibiotic Consumption among 89 China Tertiary General Hospitals from 2011Q1 to 2015Q4

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