eISSN : 2146-9369
Creative Commons Lisansı
Journal of Clinical and Experimental Investigations is licenced under the terms of Creative Commons Attribution-Non Commercial4.0 International (CC BY-NC 4.0) License.
Abstract - Antibiotic use and cost in a teaching hospital in İstanbul
Asuman İnan, Özgür Dağlı, Seniha Şenbayrak Akçay, Derya Öztürk Engin, Emin Karagül, Seyfi Çelik Özyürek

 

Antibiotic use and cost in a teaching hospital in İstanbul

Asuman İnan1, Özgür Dağlı1, Seniha Şenbayrak Akçay2, Derya Öztürk Engin1, Emin Karagül1, Seyfi Çelik Özyürek1

1Department of Infectious Diseases and Clinical Microbiology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey

2Department of Clinical Microbiology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey

ABSTRACT

Objectives: The aims of this study were to determine the usage patterns and the cost of antibiotics, along with the evaluation of the effects of infectious diseases (ID) specialists on appropriate antimicrobial use in hospitalized patients.

Materials and methods: A one-day, cross-sectional study was conducted in a major tertiary hospital and data on the use of antibiotics were collected by using a standard form. The appropriateness of the antibiotic usage was evaluated using the Council for Appropriate and Rational Antibiotic Therapy (CARAT) criteria; and the consumption and daily cost of antibiotics were determined.

Results: On the study day, antibiotics were prescribed in 199 (35.6%) of 553 hospitalized patients, in 109 (32.9%) on the surgical and 90 patients (40.5%) on the medical wards. The total empirical antibiotic use was more frequent (49.7%) than prophylactic (29.1%) and culture-based therapy (21.2%). In 44 patients (22.1%) the antibiotics were used inappropriately; any of these antibiotics needed the approval of ID specialist. The inappropriate usage was more common in prophylactic therapy (46.5%) than empirical (16.1%) and specific antibiotic administration (2.3%). ID consultation rates were significantly higher in the appropriate antibiotic administrations (69.6%) than in the inappropriate group [(6.8%, p<0.0001), odds ratio (OR) 10.2, confidence intervals (CI) =3.0–3.7]. The total one-day cost of antibiotic therapy in our hospital was US $3350.6, and the total daily cost for hospital infection was $2137.1. The mean daily cost per patient was $2.1 for prophylaxis, $10.7 for community-acquired infections and $54.7 for hospital infections (p<0.001, OR 9.8, CI 4.7–20.7).

Conclusion: This study showed that antibiotic prescription rates are high, surgical prophylaxis is still a major problem in our hospital, ID approval is effective for appropriate use of antibiotics, and the antibiotic cost of hospital infections is an important part of extra costs. J Microbiol Infect Dis 2011;1 (3):128-133

Key words: Antibiotics, rational use, cost

Volume 01, Number 03 (2011)