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