Trends in antibiotic use at a university hospital: Defined or prescribed daily doses? Patient days or admissions as denominator?
Trends in antibiotic use at a university hospital: Defined or prescribed daily doses? Patient days or admissions as denominator?
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DOI：
10.1007/s15010-006-5085-9
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发表时间：
2006-04-01
期刊：
影响因子：
7.5
通讯作者：
Kern, W. V.
中科院分区：
文献类型：
--
作者：
de With, K.;Maier, L.;Kern, W. V.
背景资料：医院抗生素使用可以通过计算WHO/ATC指数（DDD）定义的每日剂量除以患者或占用床天数来衡量。我们想知道，当与不同的替代剂量定义和入院次数（而不是患者天数）作为分母时，使用这种数据格式的大学医院抗生素使用密度随时间的变化是否在数量级上相似。方法：从医院药房获得的数据，用于医疗和外科服务，1992年至2003年期间，1000张床位的大学医院的日剂量以每100个患者日的日剂量和每次入院的日剂量表示。将PDD剂量定义（处方日剂量）与WHO/ATC 2001 DDD剂量定义进行了比较，定义的剂量反映了肾功能正常的成人住院患者的通常处方剂量。使用不同的数据格式之间的两个3年的平均值（1992-1994年和2001-2003年）的百分比变化counted.Results和结论：DDD/100患者天的数据格式高估了抗生素使用密度的变化，在这家医院的药物（81%与48%），以及在手术（69%与39%）相比，PDD/100患者天。由于多年来住院人数和住院时间的变化，以每100患者日剂量表示的两个时期之间的百分比变化与使用每次住院DDD或每次住院PDD数据格式估计的变化有很大差异。评价医院抗生素使用演变的研究需要解决不同数据格式的局限性和充分性。
Background: Hospital antibiotic use can be measured by calculating daily doses as defined by the WHO/ATC index (DDD) divided by the number of patient or occupied bed days. We wondered whether changes in antibiotic use density over time at a university hospital using this data format are similar in order of magnitude when compared with a different, alternative dose definition and the number of admissions rather than the number of patient days as denominator.Methods: Data obtained from the hospital pharmacy for the medical and surgical services of a 1,000-bed university hospital for the period 1992 through 2003 were expressed both in daily doses per 100 patient days and daily doses per admission. A PDD dose definition (prescribed daily doses), defining doses that reflect the usually prescribed dose in adult hospitalized patients with normal renal function was compared with the WHO/ATC 2001 DDD dose definitions. The percent changes using the different data formats between two 3-year averages (1992-1994 and 2001-2003) were calculated.Results and Conclusion: The DDD/100 patient days data format overestimated antibiotic use density changes in this hospital both in medicine (81% vs 48%) as well as in surgery (69% vs 39%) when compared with PDD/100 patient days. Due to changes in the number of admissions and Length of stay over the years, the percent change between the two periods expressed in doses per 100 patient days in addition differed substantially from that estimated by using the DDD per admission or PDD per admission data format. Studies evaluating the evolution of hospital antibiotic use need to address the Limitations and adequacy of the different data formats.