A comparative study on the antibiotic consumption of two Hungarian county hospitals

Abstract number: 1733_598

Almási I., Ternák G., Rozgonyi F.

Objectives: The aim of this study was to analyse the changes in the antibiotic consumptions and indications of antibiotic prescription in two similar size hospitals in order to see the quality of antibiotic usage.

Methods: Case histories and the conditions of antibiotic treatment of patients such as considerations of indication, choice and name of antibiotics, treating dose and durations, microbiological examinations, etc were put in a computer database. Date of patients discharged from the hospitals in January 1995 and 2005, respectively, were analysed and compared in both hospitals. An antibiotic policy and infection control was implemented in both hospitals in 1995.

Results: Data of 2230 and 3031 patients from Hospital 1 (H1) and data of 1240 and 1809 patients from Hospital 2 (H2) in the year 1995 and 2005 were compared. Here we focus on the features of the antibiotic consumption. In the two periods, systemic antibiotic treatment was given to 24.7% and 18.4% of the patients in H1, while to 28.7% and 27.5% of the patients in H2. Surgical proplylaxis became the most frequent indication for antibiotic treatment: from 11.7% to 34.7% in H1, and from 6.7% to 35.6% in H2. Lower respiratory and urinary tract infections, respectively, were the next frequent indications. Rates of fever or unidentified indications for antibiotic treatment decreased remarkably. The usage of b-lactams increased in both H1 and H2: from 55.2% to 68.2% and from 51.0% to 58.2%. The usage of an aminopenicillin+b-lactamase inhibitor increased significantly: from 3.5% to 30.1% in H1 and from 5.5% to 36.5% in H2. The rates of both the prescription of multiple antibiotics under the same hospital stay and the combined antibiotic therapy decreased in both hospitals: from 33.8 to 24.0% in H1 and from 36.0% to 22.9% in H2 (concerning No. of patients), as well as from 16.0% to 11.2% in H1 and from 13.9% to 12.6% in H2 (concerning antibiotic courses).

Conclusion: The antibiotic policy and infection control guidelines were followed by the clinicians in both hospitals. These resulted in a better structure of the antibiotic consumption. These were mainly due to the more appropiate surgical antibiotic prophylaxis during the ten years.