engleski

Use of new antiepileptic drugs (AED) at the University Hospital in Croatia

Purpose: In Croatia there are three new AEDs approved for clinical use lamotrigine (LTG) in 1995, vigabatrine (VGB) in 1997 and topiramate (TPM) in 1998. The aim of this study was to analyse the use of new AEDs at the University Hospital Centre (UHC) Rijeka, the second biggest hospital in the country, covering a population of 500.000 inhabitants. Method: AED use was monitored at the UHC Rijeka in 2001, in the clinics. Results are presented as defined daily doses per 100 bed days (DDDs/100 BD) and their percentages. DDDs published in ATC index, 2000, were used. Results: The most common AEDs used were phenobarbital and methyl-phenobarbital (77.8%). Valproic acid (5.8%) and carbamazepine (8.7%) were used far less. Usage of new AEDs was insignificant (2.6%). AEDs were mostly prescribed at departments of paediatrics, psychiatry and neurology and in the neurosurgery ward, where their use accounted for 68% of total AED usage at the UHC Rijeka. At the department of neurology the most commonly prescribed AEDs were barbiturates (87%). At the neurosurgery ward the only AED used was phenobarbital. At the department of psychiatry the most commonly prescribed AEDs were barbiturates, carbamazepine, benzodiazepines with usage of new AEDs only 0.49%. The broader use of various AEDs was found only at the department of paediatrics, with 26.4% of patients receiving the new AEDs. Conclusions: According to our results, use of new AEDs at the UHC Rijeka is very low, 2.6%, resulting in possible inappropriate treatment of patients with epilepsy. The exception is the paediatric population where the use of new AEDs corresponds to the incidence of resistant epilepsy in children. Further investigation is needed to bring firm conclusions regarding AEDs use linked to diagnoses, as well as to evaluate out-patient AEDs use. However, university hospitals should be leaders in promoting new and/or promising epilepsy treatment.

epilepsy; antiepileptic drugs; utilisation

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