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Volume 27, Issue 3

Original Article

Evaluation of Antibiotic Consumption in a University Hospital

Gülden Yılmaz
Affiliations
  • Ankara Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Ankara, Türkiye
,
Elif Mukime Öztürk
Affiliations
  • Ankara Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Ankara, Türkiye
,
Müge Ayhan
Affiliations
  • Ankara Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Ankara, Türkiye
,
Belgin Coşkun
Affiliations
  • Ankara Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Ankara, Türkiye
,
Alpay Azap
Affiliations
  • Ankara Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Ankara, Türkiye
  • Antibacterial agents
  • antibiotic resistance
  • point prevalence

Abstract

Objective: Increased side effects, treatment failures, high morbidity, mortality and antimicrobial resistance are the results of inappropriate usage of antibiotics. In this study antibiotic consumption in a university hospital was evaluated.

Methods: All inpatients that were receiving antimicrobial treatment at the hospital on the day of the survey were included in the study. The following data were collected: age and gender of the patient, hospital ward, existence of Infectious Diseases and Clinical Microbiology (IDCM) consultation and compliance with consultation, dosage, route of administration and indication of the used antibiotics.

Results: Of 1058 patients, 392 (37%) were receiving antimicrobial treatment and the total number of antimicrobials prescribed was 609 on the day of the survey. 57% of patients receiving antimicrobial treatment were in the intensive care units. Antimicrobial usage was appropriate in 291 (74.2%) patients while 101 (25.8%) received at least one inappropriate antimicrobial. The percentage of the appropriate antimicrobial usage was higher in internal medicine wards than in surgical wards (85% versus 65%) (p<0.001). Appropriateness of antibiotics which were prescribed without an IDCM consultation was also higher in internal medicine wards than in surgical wards (71% vs. 48%) (p<0.001). The most frequent cause of noncompliance with IDCM consultation was erroneous dosing. Appropriate antimicrobial usage was highest in restricted antimicrobial group of nationwide antibiotic restriction program (95%) and lowest in antimicrobial group which can be prescribed without any restriction (52%) (p<0.001). Of the antimicrobials used for prophylaxis, 69% were inappropriate while in 33%, prophylaxis was unnecessary. Interestingly, 6.5% of the antibiotics prescribed for targeted therapy were inappropriate.

Conclusions: Judicious antibiotic usage is important for preventing antimicrobial resistance and reducing costs. As seen in our study, all prescribed antimicrobials should be monitored in terms of indication, dosage and adverse effects. Further improvement must be planned accordingly. 

  • 109-113
  • 10.5152/kd.2014.31
  • July 23, 2019
  • 2167
  • 655
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  • This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License. CC BY-NC
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