Evaluation of the therapeutic use of antibiotics in Aegean Region hospitals of Turkey: A multicentric study

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Date: April-June 2011
From: Indian Journal of Medical Microbiology(Vol. 29, Issue 2)
Publisher: Elsevier B.V.
Document Type: Report
Length: 3,350 words
Lexile Measure: 1670L

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Byline: O. Ozgenc, V. Genc, A. Ari, E. Sibel, S. Sacar, H. Ozunlu, A. Akgul, N. Demirturk, C. Cetin, M. Sungur, S. Coskuner, Meltem. Avci, O. Ergonul, Antibiotic Resistance Study Group of Turkish Association of Clinical Microbiology and Infectious Diseases.

Purpose: The antibiotic restriction policy has been validated nationwide since February 2003 by the Ministry of Health because the excessive consumption of antimicrobials causes a high cost. The aim of this study was to evaluate the therapeutic use of antibiotics in Aegean Region hospitals and to assess the impact of this nationwide antibiotic restriction policy. This new policy is based on justification that the infectious disease (ID) physicians should be primarily responsible for the prescription of antimicrobials. Materials and Methods: Eight university and government hospitals were included in the study. The criteria of the Council for Appropriate and Rational Antibiotic Therapy (CARAT) were considered. Both patient-based and antibiotic-based analyses were performed. For the analysis of inappropriate use, logistic regression was modeled. Results: Therapeutic use was determined in 540 patients by a total of 29 ID physicians.In the study, 30.2% of the patients were given antimicrobials and empirically started antibiotics accounted for 79% cases of therapeutic antibiotic use, and 60% of those were inappropriate (P = 0.001). The appropriate use of ID level antibiotics (P = 0.000) were very compatible with other antimicrobial groups. Conclusion: The study shows that the Turkish government's new intervention policy on antimicrobial prescribing has been effective.

Introduction

There is an increasing concern and awareness of antibiotic resistance problems worldwide. The inappropriate use of these antimicrobials in hospitals contributes to the emergence and spread of drug-resistant microorganisms and increased treatment expenditures. [sup][1] Because the excessive consumption of antimicrobials causes a high cost, the antibiotic restriction policy has been validated nationwide since February 2003 by the Ministry of Health. This new policy is based on the justification that the infectious disease specialist (ID) physicians should be primarily responsible for the prescription of antimicrobials. [sup][2]

The aim of this study was to evaluate the therapeutic use of antibiotics in Aegean region hospitals and to assess the impact of this nationwide antibiotic restriction policy, and then, to develop rational antibiotic implementation protocols to prevent resistance as the Antibiotic Resistance Study Group of Turkish Association of Clinical Microbiology and Infectious Diseases.

Materials and Methods

Hospital setting and study population

Eight university and government hospitals were included in the study. Among these two were teaching and research hospitals, and three of them were university hospitals. Two community hospitals were not education and research oriented. All the patients hospitalized 24-h and were over age 15 who received antibiotics were evaluated by a cross-sectional study.

Current antibiotic implementation policy in Turkey

The Turkish government regulation was based on a two-level restriction (strict infectious disease-ID level and A-72 level) of antimicrobial prescriptions at the hospitals. The strict infectious disease (ID) physician level approval includes liposomal amphotericin B, caspofungin, voriconazole, piperacillin-tazobactam, cefoperazone-sulbactam, cefepime, meropenem, imipenem-cilastatin, teicoplanin, and vancomycin. The A-72 level antibiotics include piperacillin, cefoperazone, ceftriaxone,...

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Gale Document Number: GALE|A258786405