engleski

Factors influencing antimicrobial utilization at a university hospital during a period of 11 years

Objective: A number of factors may influence antibiotics prescribing. The objective of this study was to identify trends in antimicrobial prescribing during a period of 11 years at the University Hospital Centre Rijeka (UHC), Croatia, and identify possible factors that might have influenced changes in prescribing patterns.This may help in establishing criteria for future intervention. Methods: Antimicrobial utilisation was evaluated retrospectively for 11 years: from 1990 to 2000. It was measured in defined daily doses (DDDs) per 100 bed days using ATC Index with DDDs 2000. Results: During the investigation period great differences were noted in total and individual antimicrobial consumption. In the first four years of this study, the utilisation of all groups of antimicrobials decreased, while in its second part (i.e., from 1995 to 1997) an increase in utilisation of all antimicrobial groups occured. Changes in utilisation of groups of antimicrobials did not coincide completely with the changes in total antimicrobial utilisation. The most prominent changes were a decrease in penicillin and cephalosporin utilisation, and an increase of macrolides and aminoglycosides utilisation from 1997 to 2000. Ampicillin and cefalexin were mostly prescribed as single antibiotics during a five year period (1990 to 1995) with the exception of one year (1994) when a great decline in antimicrobial utilisation was noted). In the following years amoxicillin and amoxicillin with enzyme inhibitor became the mostly used antimicrobials. Conclusion: Different factors were found to influence antimicrobial utilisation during the investigation period. There were factors that directly influenced prescribing: physician's prescribing habit, guidelines, policy and formulary, but also factors that directly influenced utilisation: availability of a drug through purchasing, dispensing, procurement, pricing etc.

antimicrobial utilization; hospital; antibiotics; defined daily dose

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