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izvor podataka: crosbi

Variation in antibiotic use among and within different settings: a systematic review (CROSBI ID 271253)

Prilog u časopisu | pregledni rad (znanstveni) | međunarodna recenzija

Zanichelli, Veronica ; Monnier, Annelie A ; Gyssens, Inge C ; Adriaenssens, Niels ; Versporten, Ann ; Pulcini, Céline ; Le Maréchal, Marion ; Tebano, Gianpiero ; Vlahović-Palčevski, Vera ; Stanić Benić, Mirjana et al. Variation in antibiotic use among and within different settings: a systematic review // Journal of antimicrobial chemotherapy, 73 (2018), suppl_6; vi17-vi29. doi: 10.1093/jac/dky115

Podaci o odgovornosti

Zanichelli, Veronica ; Monnier, Annelie A ; Gyssens, Inge C ; Adriaenssens, Niels ; Versporten, Ann ; Pulcini, Céline ; Le Maréchal, Marion ; Tebano, Gianpiero ; Vlahović-Palčevski, Vera ; Stanić Benić, Mirjana ; Milanič, Romina ; Harbarth, Stephan ; Hulscher, Marlies E ; Huttner, Benedikt

engleski

Variation in antibiotic use among and within different settings: a systematic review

Objectives Variation in antibiotic use may reflect inappropriate use. We aimed to systematically describe the variation in measures for antibiotic use among settings or providers. This study was conducted as part of the innovative medicines initiative (IMI)-funded international project DRIVE-AB. Methods We searched for studies published in MEDLINE from January 2004 to January 2015 reporting variation in measures for systemic antibiotic use (e.g. DDDs) in inpatient and outpatient settings. The ratio between a study’s reported maximum and minimum values of a given measure [maximum:minimum ratio (MMR)] was calculated as a measure of variation. Similar measures were grouped into categories and when possible the overall median ratio and IQR were calculated. Results One hundred and forty-three studies were included, of which 85 (59.4%) were conducted in Europe and 12 (8.4%) in low- to middle-income countries. Most studies described the variation in the quantity of antibiotic use in the inpatient setting (81/143, 56.6%), especially among hospitals (41/81, 50.6%). The most frequent measure was DDDs with different denominators, reported in 23/81 (28.4%) inpatient studies and in 28/62 (45.2%) outpatient studies. For this measure, we found a median MMR of 3.7 (IQR 2.6–5.0) in 4 studies reporting antibiotic use in ICUs in DDDs/1000 patient-days and a median MMR of 2.3 (IQR 1.5– 3.2) in 18 studies reporting outpatient antibiotic use in DDDs/1000 inhabitant-days. Substantial variation was also identified in other measures. Conclusions Our review confirms the large variation in antibiotic use even across similar settings and providers. Data from low- and middle-income countries are under- represented. Further studies should try to better elucidate reasons for the observed variation to facilitate interventions that reduce unwarranted practice variation. In addition, the heterogeneity of reported measures clearly shows that there is need for standardization.

antibiotics ; incomeinpatients ; outpatients

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Podaci o izdanju

73 (suppl_6)

2018.

vi17-vi29

objavljeno

0305-7453

1460-2091

10.1093/jac/dky115

Povezanost rada

Javno zdravstvo i zdravstvena zaštita, Kliničke medicinske znanosti

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