The effect of a restriction policy on the antimicrobial consumption in Turkey: a country-wide study

Hoşoğlu, Salih; Esen, Şaban; Öztürk, Recep; Altındiş, Mustafa; Ertek, Mustafa; Kaygusuz, Sedat; Çaylan, Refik; Demirdag, Kutbettin; Şencan, İrfan; Ertem, Günay Tuncer; Aslan, Selda; Boşnak, Vuslat; Aygun, Pakize; Erol, Serpil; Çelen, Mustafa Kemal

doi:10.1007/s00228-005-0968-8

Cited by 32 publications

(34 citation statements)

References 19 publications

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“…Antimicrobials are among the most costly drug expenditures in Turkey, accounting for 24% of total spending on medicines, and the rate of antimicrobial use has previously been found to be increasing. 2 Turkey has a total population of 71.3 million. Pharmaceuticals accounted for up to 33.5% of the total health expenditure in 2000.…”

Section: Introductionmentioning

confidence: 99%

Increased antimicrobial consumption following reimbursement reform in Turkey

Karabay¹,

Hoşoğlu²

2008

Journal of Antimicrobial Chemotherapy

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Section: Introductionmentioning

confidence: 99%

Increased antimicrobial consumption following reimbursement reform in Turkey

Karabay¹,

Hoşoğlu²

2008

Journal of Antimicrobial Chemotherapy

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“…A new restriction on antimicrobials was implemented as a method to improve antimicrobial drug use by May 2003. After May 2003, the reimbursement of wide-spectrum antimicrobials was cut, unless it was approved by an Infectious Diseases Physician (IDP) [10].…”

Section: Introductionmentioning

confidence: 99%

Critical evaluation of antimicrobial use - A Turkish university hospital example

Hoşoğlu

Parlak

Geyik

et al. 2013

J Infect Dev Ctries

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Introduction: Antimicrobials are being used unnecessarily for different reasons. The aims of this study were: assessment of the quality of antimicrobial use and determination of the factors related to correct use. Method: Antimicrobial practice at Dicle University Hospital (DUH) was evaluated with a point prevalence approach. Using a standardized data collection form, the patients' data (clinic, epidemiology, laboratory and antimicrobial use) was collected. Possible influential factors on antimicrobial use were examined. Results: In the surveillance study 1,350 inpatients were evaluated; 461 (34.1%) of them were using antimicrobials for treatment and 187 (13.9%) for prophylaxis. Antimicrobial indication was found in 355 of 461 patients (77.0%), and the number of antimicrobials was 1.8 per patient in the treatment group. The most common reason for antimicrobial use was community-acquired infection (57.9%). Pneumonia (20.4%), skin and soft tissue infections (9.11%) and urinary tract infections (7.9%) were the most common infectious diseases. Positive culture results were available for 39 patients (8.5.0%) when antimicrobial treatment started. All steps of antimicrobial use were found appropriate in 243 patients (52.7%). In multivariate analyses, clinical manifestation of infection at the beginning (p<0.001), presence of leukocyte counting (p<0.001) and prescription by an infectious disease specialist were found significantly positive factors for wholly appropriate antimicrobial use. Hospitalization with a diagnosis other than infection was found a significantly negative factor for appropriate antimicrobial use (p=0.001). Conclusion: The quality of antimicrobial use could be improved with better clinical and laboratory diagnosis and consultation with infectious diseases specialists

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“…Hosoglu et al [14], in 15 hospitals in Turkey before and 6 months after BAI, informed that antimicrobial consumption was decreased 26.4% after BAI.…”

Section: Discussionmentioning

confidence: 99%

Effects of Legal Antibiotic Restrictions on Consumption of Broad-Spectrum Beta-Lactam Antibiotics, Glycopeptides and Amphotericin B

Kurt

Karabay²,

Birengel

et al. 2010

Chemotherapy

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In 2002, antimicrobial drugs were the most frequently prescribed drugs in Turkey. On February 15, 2003, the Turkish Government implemented a new Budget Application Instruction (BAI) to promote rational antibiotic usage in order to decrease the costs. This BAI restricted the reimbursement of certain antibiotics without prescription or approval by the infectious diseases specialists (IDS). The purpose of this study is to evaluate the effect of BAI on antibiotic consumption for the 3 years before and 2 years after its implementation, according to IMS Health Office findings. Based on the data of the IMS Health Turkey Office, the amount of some broad-spectrum antibiotics (piperacillin/tazobactam, imipenem, meropenem, cefoperazone/sulbactam, ceftazidime, cefepime, teicoplanin, vancomycin, and amphotericin B) that were prescribed by IDS between 2000 and 2002 and between 2003 and 2004 are determined. The Anatomical Therapeutic Chemical classification and the defined daily dose (DDD)/1,000 methodology are used to calculate antibiotic consumption. Total antibiotic consumption before BAI, in 2000, 2001 and 2002 was 0.091, 0.107 and 0.119 DDD/1,000 inhabitant-days, respectively, and after BAI, in 2003 and 2004, 0.137 and 0.135 DDD/1,000 inhabitant-days, respectively. Average utilization of antibiotics before the implementation of BAI was 0.105 DDD and increased to 0.136 DDD after BAI. Antibiotic consumption has increased 1.3-fold after the implementation of BAI. However, the effect of restricted antibiotic utilization was revealed especially in the second year after BAI. The consumption of antimicrobials decreased to 0.135 in 2004 while it was 0.137 in 2003.

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The effect of a restriction policy on the antimicrobial consumption in Turkey: a country-wide study

Abstract: The study shows that the implementation of the new policy resulted in a significant reduction in the prescription of antimicrobials.

Cited by 32 publications

References 19 publications

Increased antimicrobial consumption following reimbursement reform in Turkey

Increased antimicrobial consumption following reimbursement reform in Turkey

Critical evaluation of antimicrobial use - A Turkish university hospital example

Effects of Legal Antibiotic Restrictions on Consumption of Broad-Spectrum Beta-Lactam Antibiotics, Glycopeptides and Amphotericin B

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