Smita Anand Tiwari1, Balasheb Baburao Ghongane2, Bharti Ramchandra Daswani3, Sangeeta Sanjay Dabhade3. 1. Assistant Professor, Department of Pharmacology, B.J. Government Medical College, Pune, Maharashtra, India. 2. Professor and Head, Department of Pharmacology, B.J. Government Medical College, Pune, Maharashtra, India. 3. Associate Professor, Department of Pharmacology, B.J. Government Medical College, Pune, Maharashtra, India.
Abstract
INTRODUCTION: The indoor hospital use of antibiotic irrationally has been a growing concern in the recent past. For the patients and providers of health care services this kind of drug consumption account for a major chunk of the budget. AIM: To assess the outcome of restriction on the use of parenteral antibiotics with respect to their utilization and monetary benefits, in a tertiary care hospital in India. MATERIALS AND METHODS: Data details were collected regarding drug utilization two months before and after restriction respectively. A total 1605 patient records assessed. Drug utilization was expressed as DDD/100 patient bed days. Use of Carbapenems were restricted to culture positive cases only. Antibiotics started for patients as per clinical judgment were issued for only five days. Culture sensitivity reports verified physically on a special indent form, before every antibiotic issued thereafter. RESULTS: Piperacillin-tazobactum (DDD/100 BD 1.72 before and 1.29 after restrictions) was the commonly used antibiotic. Considering values expressed in DDD/100 BD before and after restriction respectively, substantial decrease in consumption of antibiotics like Imipenem- Cilastin (0.22 to 0.16), meropenem (0.30 to 0.09), piperacillin-tazobactum (1.72 to 1.29), teicoplanin (0.24 to 0.05) and vancomycin (0.69 to 0.40) was observed. An increase in consumption of amoxicillin-clavulanic acid (0.90 to 1.04) and clarithromycin (0.44 to 0.55) noted, pointing to a shift in antibiotic use. Restriction decreased expenditure burden on these antibiotics by INR 1,45,911 (17.31%). CONCLUSION: Restriction of antibiotics cuts down consumption and benefits hospital budget immensely.
INTRODUCTION: The indoor hospital use of antibiotic irrationally has been a growing concern in the recent past. For the patients and providers of health care services this kind of drug consumption account for a major chunk of the budget. AIM: To assess the outcome of restriction on the use of parenteral antibiotics with respect to their utilization and monetary benefits, in a tertiary care hospital in India. MATERIALS AND METHODS: Data details were collected regarding drug utilization two months before and after restriction respectively. A total 1605 patient records assessed. Drug utilization was expressed as DDD/100 patient bed days. Use of Carbapenems were restricted to culture positive cases only. Antibiotics started for patients as per clinical judgment were issued for only five days. Culture sensitivity reports verified physically on a special indent form, before every antibiotic issued thereafter. RESULTS:Piperacillin-tazobactum (DDD/100 BD 1.72 before and 1.29 after restrictions) was the commonly used antibiotic. Considering values expressed in DDD/100 BD before and after restriction respectively, substantial decrease in consumption of antibiotics like Imipenem- Cilastin (0.22 to 0.16), meropenem (0.30 to 0.09), piperacillin-tazobactum (1.72 to 1.29), teicoplanin (0.24 to 0.05) and vancomycin (0.69 to 0.40) was observed. An increase in consumption of amoxicillin-clavulanic acid (0.90 to 1.04) and clarithromycin (0.44 to 0.55) noted, pointing to a shift in antibiotic use. Restriction decreased expenditure burden on these antibiotics by INR 1,45,911 (17.31%). CONCLUSION: Restriction of antibiotics cuts down consumption and benefits hospital budget immensely.
Entities:
Keywords:
Drug audit; Drug consumption; Injectable antimicrobials; Pharmacoeconomics
Authors: W Zhang; X Liu; Y Wang; Y Chen; M Huang; M Fan; M Lu; Y Huang; L Wang; K Yao; S Yu; X Shen; Y Yang Journal: J Clin Pharm Ther Date: 2009-02 Impact factor: 2.512