Antibiotic usage peculiarities in Lithuanian hospitals revealed by national prevalence study

Abstract number: 1134_01_117

Valinteliene R., Griskeviciene J.

Objectives:  

Study antibiotic usage in Lithuanian hospitals and identify week points of antibiotic consumption monitoring system. Monitoring antibiotic consumption is one of the key activities in combating antimicrobial resistance. Lithuania is one of the few countries in Europe that is just starting to obtain antibiotic consumption data, primarily from hospitals.

Methods:  

Point prevalence study in representative number of Lithuanian hospitals was performed. Data on current antibiotic treatment (antibiotic name, route of admission, reason) as well as on infections were collected for all hospitalized patients during bed rounds. All antibiotics were recorded: those offered by hospital as well as those prescribed by doctors but bought by patients themselves (last mentioned drugs are not included in official hospital's consumption data). The study included 10102 patients in 39 hospitals.

Results:  

One third of patients were given antibiotics (3140 patients, 31.1%) and in 77.9% of cases it was monotherapy. In general, 3943 antibiotics were prescribed and most of them (74.8%, 2948) were prescribed for the treatment of infections while 24.8% (979) as prophylaxis (unknown - 0.4%, 16). Most often used were penicillin (23.4%), aminopenicillins (19.2%), aminoglycosides (21.2) and cephalosporins (15.5%). When structure of antibiotic was compared with antibiotic consumption data officially obtained from hospitals some differences were detected. During our study it was determined that 6.2% of all used antibiotics were obtained by patients themselves (these are not coming in official consumption data). Great variations between hospitals and units in this respect were observed. There were 5 hospitals where more than 20% (up to 50%) of antibiotics were bought by patients. More often patient's own antibiotics were used in surgical departments: orthopaedic/trauma (12.9%), general surgery (7.3%). It was determined that antibiotics for prophylaxis (12.3%) are tend to be more often bought by patients than for treatment (4.0%). It also was found out that patients more often are asked to buy certain antibiotics: III–IV gen. cephalosporins (27.8%), quinolons (18.4%), I–II gen. cephalosporins (13.7%).

Conclusion:  

Antibiotic consumption monitoring based only on data from hospital pharmacies might be inaccurate, especially for prophylactic usage, total consumption in surgical departments and some certain drugs (III–IV gen. cephalosporins, quinolons).