Methodology for Electronic Monitoring of Quality Drug Prescriptions in Phthisiopulmonology

Abstract

Background: The problem of increasing antibiotic resistance, decrease in the quality of treatment and its inefficiency, the prolongation of terms of hospitalization, development of nosocomial infections, and increasing treatment costs leads to significant social and financial losses. Based on international recommendations and consideration of the microbial landscape the local strategy for the use of antibacterial drugs was developed and implemented. Methods: In this study, an analysis of the effectiveness of the rational use of antibiotics comparing results of 2014 and 2015 was conducted: Selection of the most significant nosocomial pathogens and determination of their antibiotic susceptibility (in percentages) ABC / VEN-analysis of antimicrobial agents Calculation of ATC / DDD usage of antimicrobials Results: of 2015 compared to 2014: Despite the growth of antibiotic resistance strains of Acinetobacter spp, improvement in antibiotic susceptibility is noticable (depending on the drug) Staphilococcus aureus from 2.5% to 38.8%; Pseudomonas aeruginosa from 1.1% to 13.2%; Klebsiella pneumonia from 5% to 40.3%; E coli 5,5-32,2%.The decrease in the cost of antibiotics by 3.8%. The decrease in ATC / DDD consumption (for 22 antibiotics), except for piperacillin tazobactam with the DDD 0.47 to 0.66; meropenem from 1.69 to 2.23; cefoperazone / sulbactam from 0.39 to 0.79 and gentamicin from 0.13 to 48.99. Conclusions: Ongoing efforts to rationalize the use of antimicrobials and the containment of antimicrobial resistance in a multidisciplinary hospital should be comprehensive, in coordination of representatives of different specializations, which in the future will increase efficiency of treatment and reduce the hospitalization time of the patient.Even minor positive indicators give hope that activities were carried out in the right direction.

A New Paradigm for Ensuring Digital Drug Care Quality Monitoring Based on Ontology Tools

“…This requires to accelerate the improvement and harmonization of the scientific terms and concepts in medicine. The vocabulary of the terms and concepts for the components of patients' diagnosis at the Clinical Situationsstage, phase, severity of Clinical status of the patient and complexity of the Clinical Situation were formulated by the authors, published and used for coding the detailed patients' diagnosis [9,13,14]. The medical electronic platforms for monitoring of medication care, decision support, predicting the adverse events are in emergence of demand for unambiguous of terms and definitions in order to collect the clinical diagnosis with exact details in codes in databases without disclosure of the private information about the patient.…”