Vol.12, No 3, 2005 pp. 174 - 178
UC 615.33

APPLICATION OF THE ATC/DDD METHODOLOGY
TO COMPARE ANTIBIOTIC UTILIZATION
IN TWO UNIVERSITY HOSPITAL SURGICAL DEPARTMENTS
Gordana Pešić, Zorica Jović, Karin Vasić
Department of Pharmacology and Toxicology, Medical Faculty, University of Niš, Serbia and Montenegro
E-mail: karin12675@yahoo.com

Summary. To analyze overall drug consumption, compare antibiotic utilization in particular, and evaluate whether sound principles of surgical prophylaxis are applied at urology clinics of two university hospitals.
The study was carried out at the urology clinics of the Department of Surgery, University Clinical Center in Niš, and the Institute of Surgery, University Teaching Hospital in Novi Sad, Serbia. Anti-microbial consumption was calculated during a two month period as the number of Defined Daily Doses (DDDs) per 100 bed days (BD) for all antiinfectives for systemic use, i.e. group J of the Anatomical Therapeutic Chemical (ATC) classification and for classes of this group.
Antibiotics are the most frequently prescribed drug group at the Urology Clinic in Niš, amounting to 263.54 DDD/100 BD (43.05 % of total drug consumption). Co-trimoxazole (204.35 DDD/100 BD), quinolones (29.81 DDD/100 BD) and aminoglycosides (18.88 DDD/100 BD) were prescribed most. In Novi Sad, antibiotic utilization amounted to 224.85 DDD/100 BD. Similarly, co-trimoxazole was most frequently prescribed (129.03 DDD/100 BD), followed by cephalosporins (43,54 DDD/100 BD) and aminoglycosides (20.5 DDD/100 BD).
In most instances, the chosen antibiotics for surgical prophylaxis were in accordance with the international guidelines. However, overuse was noted extending to the postoperative period. We believe that indications for the anti-microbial use still need a critical evaluation and that irrational use should be discouraged.
Key words: Antibiotic utilization, surgical prophylaxis, anatomical therapeutic chemical classification, defined daily doses


ANALIZA UPOTREBE ANTIMIKROBNIH LEKOVA PRIMENOM ATC/DDD METODOLOGIJE NA DVE UNIVERZITETSKE HIRURŠKE KLINIKE
Kratak sadržaj: Farmakoterapijska praksa se formira pod uticajem faktora koji deluju na stvaranje propisivačkih navika pojedinih lekara. Poznavanje farmakoterapijske tradicije na nekom području omogućava sprovodjenje edukativnih programa racionalne farmakoterapije. Cilj našeg rada je bio da analiziramo i uporedimo upotrebu lekova, posebno antibiotika, na klinikama za urologiju u Nišu i Novom Sadu kako bi procenili da li su sprovedeni principi hirurške profilakse bili u sladu sa medjunarodnim smernicama.
U ovom radu ispitivanje je izvršeno na odeljenjima za urologiju hirurških klinika u Nišu i Novom Sadu. U analizi upotrebe antiinfektivnih lekova za sistemsku primenu, i svih lekova uopšte, korišćena je jedinica mere definisana dnevna doza (DDD) na 100 bolesničkih dana (BD). Lekovi su razvrstani po Anatomsko-Terapijsko-Hemijskoj (ATC) klasifikaciji.
Antibiotici (grupa J po ATC klasifikaciji) su predstavljali najzastupljeniju grupu u ukupnoj upotrebi u Nišu sa 263,54 DDD/100 BD (43,05% od ukupne upotrebe). Kotrimoksazol (204,35 DDD), hinoloni (29,81 DDD) i aminoglikozidi (18,88 DDD) su bili najviše propisivane grupe antibiotika. U Novom Sadu, upotreba antiinfektivnih lekova iznosila je 224,85 DDD/100 BD. Slično situaciji u Nišu, i ovde je kotrimoksazol najčešće propisivan (129,03 DDD), zatim cefalosporini (43,54 DDD) i aminoglikozidi (20,5 DDD).
U najvećem broju slučajeva izbor antibiotika za hiruršku profilaksu bio je u skladu sa medjunarodnim smernicama. Medjutim, primećena je prekomerna upotreba antibiotika s obzirom na ordiniranje istih u postoperativnom periodu bez jasnih dokaza o infekciji. Smatramo da treba postaviti jasne indikacije za primenu antibiotika u hirurškoj profilaksi kako bi se u daljem toku izbegla svaka neracionalna upotreba.
Ključne reči: Anatomsko-Terapijsko-Hemijska klasifikacija, definisane dnevne doze, hirurška profilaksa, antibiotici