Short-term effect of antibiotic control policy on the usage patterns and cost of antimicrobials, mortality, nosocomial infection rates and antibacterial resistance

Arda, Bilgin; Sıpahi, Oğuz Reşat; Taşbakan, Meltem; Pullukçu, Hüsnü; Tünger, Alper; Büke, Çağrı; Ulusoy, Sercan

doi:10.1016/j.jinf.2007.02.014

Cited by 50 publications

(46 citation statements)

References 22 publications

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“…Studies demonstrated that the consumption of and expenses relating to antibiotics have been reduced with the implementation of this programme. 19,20 Our results show that the consumptions of restricted antibiotics (which are allowed to be prescribed only by an infectious disease specialist) and unrestricted antibiotics are 189.6 DPD and ICUs are the departments in hospitals where antibiotics are most commonly used. It was reported that at least one antibiotic is given to 41-85% of the patients hospitalized at 484.9 DPD, respectively.…”

Section: Discussionmentioning

confidence: 83%

Antibiotic consumption in Turkish hospitals; a multi-centre point prevalence study

Güçlü

Öğütlü

Karabay

et al. 2016

Journal of Chemotherapy

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This multi-centre study aimed to determine the antibiotic consumption in Turkish hospitals by point prevalence. Antibiotic consumption of 14 centres was determined using the DDD method. Among hospitalized patients, 44.8% were using antibiotics and the total antibiotic consumption was 674.5 DDD/1000 patient-days (DPD). 189.6 (28%) DPD of the antibiotic consumption was restricted while 484.9 (72%) DPD was unrestricted. Carbapenems (24%) and beta lactam/beta lactamase inhibitors (ampicillin-sulbactam or amoxicillin-clavulanate; 22%) were the most commonly used restricted and unrestricted antibiotics. Antibiotics were most commonly used in intensive care units (1307.7 DPD). Almost half of the hospitalized patients in our hospitals were using at least one antibiotic. Moreover, among these antibiotics, the most commonly used ones were carbapenems, quinolones and cephalosporins, which are known to cause collateral damage. We think that antibiotic resistance, which is seen at considerably high rates in our hospitals, is associated with this level of consumption.

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Section: Discussionmentioning

confidence: 83%

Antibiotic consumption in Turkish hospitals; a multi-centre point prevalence study

Güçlü

Öğütlü

Karabay

et al. 2016

Journal of Chemotherapy

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“…With the restriction policy, the consumption of restricted antibiotics decreased at a ratio of 44.8% and the benefit was USD 332,000 per year. Arda et al [13], in a 1,788-bed hospital at the Ege University comparing the first 8-month period in 2003 after BAI was implemented with respect to the 8-month period in 2002 before BAI, determined a statistically important decrease in the amount and cost of antibiotics (23 and 26%). Besides, a decrease in the cost of restricted and unrestricted antibiotics was reported after BAI (19.6%, USD 540,303).…”

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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“…Bu tür kısıtlamaların direnç ve maliyet üzerine olumlu etkileri başka bir çalış-mada da açık olarak gösterilmiştir (35) . Ülkemizde yapılan çalışmalar da kısıtla-ma politikası sonrası kullanılan antibiyotik miktarlarındaki azalmayı ve direnç oranlarındaki düşmeyi açık olarak desteklemektedir (3,4,14,27) . Kısıtlama olmaksızın antibiyotik kullanı-mı yönetiminin başarılı olmadığı yapılan bir çalışmada gösterilmiştir (22) .…”

Section: Iantibiyotik Kullanımındaki Stratejiler (Antibiyotik Kullanunclassified

Antimicrobial Resistance and Prevention Policies

Akalın¹

2011

Ankem

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Short-term effect of antibiotic control policy on the usage patterns and cost of antimicrobials, mortality, nosocomial infection rates and antibacterial resistance

Cited by 50 publications

References 22 publications

Antibiotic consumption in Turkish hospitals; a multi-centre point prevalence study

Antibiotic consumption in Turkish hospitals; a multi-centre point prevalence study

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

Antimicrobial Resistance and Prevention Policies

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