Changes in the pattern of hospital intravenous antimicrobial use in Saudi Arabia, 2006–2008

Abstract

BACKGROUND AND OBJECTIVEHospitals should measure antimicrobial use based on the WHO’s recommended metric, the defined daily dose (DDD). There is no data on antimicrobial usage based on DDD in Saudi Arabia. Thus, this study evaluates the trend in antimicrobial consumption based on this concept.DESIGN AND SETTINGObservational study in a general hospital in Saudi Arabia from 2006–2008.METHODSWe analyzed the use of intravenous systemic antibacterial agents (group J01 of the Anatomical Therapeutic Chemical [ATC] classification and the classes of this group) that were administered to hospitalized patients by reviewing the data obtained from the pharmacy records. Antimicrobial consumption was calculated as the number of DDD per 100 bed-days.RESULTSOf the total parenteral antibiotics, ciprofloxacin was the most commonly used intravenous antibiotic (67.6%), followed by ceftriaxone (6%), cefazolin (5%), and imipenem-enzyme inhibitor (4.3%). The DDD per 100 patient-days usage of intravenous antimicrobial agents was as follows: J01MA02 ciprofloxacin (parenteral) 82.643, J01DD04 ceftriaxone 7.447, J01DB02 cefazolin 6.166, J01DH51 imipenem-enzyme inhibitor 5.234, J01MA12 levofloxacin 3.188, and J01XA01 vancomycin 2.97. Intravenous ciprofloxacin usage increased from 3.55 to 82.643 DDD/100 patient days.CONCLUSIONThe study showed that the most commonly used intravenous systemic antimicrobial agent was ciprofloxacin. Thus, strategies are needed to specifically target these agents for prescribing improvement.

the impact of antimicrobial stewardship strategies on antibiotic appropriateness and prescribing behaviours in selected countries in the Middle East: a systematic review

“…Eleven (61.1%) of these reported unwarranted and inappropriate use (typically overuse) of antimicrobials. The majority of the studies concluded that prescribing habits were to blame for the discrepancies observed, and that physicians were not prescribing according to local policies and guidelines (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). Conversely, 6 (33.3%) studies reported adherence to guidelines and local institutional policies (27)(28)(29)(30)(31)(32).…”

“…These included annual surveillance; infectious diseases team consultations (17,23,24,32) focusing on interdisciplinary collaboration; and good cross-departmental communication (22,23). In the majority of studies training of health care professionals, public health awareness and continuing medical education were considered to be important components that further enhance health care professionals' knowledge, and thus improve antibiotics use and overall prescribing appropriateness (13)(14)(15)19,21,(24)(25)(26). Others highlighted the importance of the role of the clinical pharmacist in monitoring prescriptions (i.e.…”

“…All studies provided recommendations for successful programme development and/ or implementation. Table 1 summarizes the studies in regard to the adoption by institutions of interventional strategies in order to assess and enhance antimicrobial use and prescribing behaviours by physicians (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32).…”

Benchmarking of antibiotic usage: An adjustment to reflect antibiotic stewardship program outcome in a hospital in Saudi Arabia

“…A better measure for comparing DDD with an external hospital, is the quantitative assessment of antibiotics use, with adjustment for severity of illness among hospitalized patients, using the case mix index (CMI) [11,14]. There are limited studies of antibiotic utilization in Saudi Arabia [15]. In this study, we compare the DDD, DOT, DDD per 100 bed-days, and the adjusted DDD according to CMI.…”

Analysis of Antimicrobial Medication Consumption in Intensive Care Unit, North West (Tabuk) Region Hospitals, Saudi Arabia

“…8 Several studies showed differences in types of antibiotics used in each country. [9][10][11][12][13] At best to the author's knowledge, there is no study done at KSA or Gulf and Middle East countries about antibiotics consumption in critical care services. The goal of the study is to explore the antibiotics consumption at critical care units in the Northern region (Tabuk) of the Kingdom of Saudi Arabia.…”