Applications of indicators as a strategy for the management of the use and cost of antimicrobials in a university hospital
DOI:
https://doi.org/10.33448/rsd-v10i6.15899Keywords:
Antimicrobial agents; Drug utilization; Drug costs.Abstract
The increase in the consumption of antimicrobials has resulted in high costs for public health, in addition to impacting the increase in microbial resistance as a worldwide problem. This study aimed to assess the consumption and economic impact of antimicrobials in a University Hospital, through the analysis of use and costs, in the period from 2015 to 2017. It is a longitudinal, analytical study with retrospective data collection. Their consumption was calculated using the indicators recommended by the World Health Organization and finally, the cost of consumption of antimicrobials was analyzed using the unit values in reais (R $). For the statistical analysis, the t test and statistical significance were used with a 95% confidence interval. By calculating the defined daily dose, the results showed a decrease in consumption in the first year, followed by an increase in consumption between years, especially the classes of carbapenems, penicillins, cephalosporins and glycopeptides. Meanwhile, the measured treatment time decreased during the study period. With regard to cost, there was a reduction between 2015 and 2016 and shortly after an increase between 2016 and 2017. It is concluded that the methods of consumption analysis are tools that guide the management of the rational use of antimicrobials and contribute to the decrease in costs in the hospital environment.
References
Apolinário, Alexsandra Conceição (2017) Polimerossomos versus lipossomos: a evolução da “bala mágica”. Química Nova, 40(7), 810-817.
Barbosa, J. A. A., Belém, L. de F., Sette, I. M. F., Farias, T. de, Pereira, G. J. da S., & Júnior, E. D. da S. (2009). Utilização de antimicrobianos em pacientes oncológicos hospitalizados. Rev. Bras. Farm. Marc 69-74.
Bell, B. G., Schellevis, F., Stobberingh, E., Goossen, H., & Pringle, M. (2014). A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infect. Dis; 9: 14:13.
Bitterman, R., Hussein, K., Leibovici, L., Carmeli, Y., & Paul, M. (2016)Systematic review of antibiotic consumption in acute care hospitals. Clin Microbiol Infect. 22(6):561.e7-561.e19
Brasil. Ministério da Saúde. Norma técnica GVIMS/GGTES ANVISA Nº 05/2017.
Cyriace, J. M., & James, E. (2014) Switch over from intravenous to oral therapy: A concise overview. J. Pharmacol Pharmacother. 5(2):83-7
Costa, J..M., Abelha, L..L., Pinto, I. V. L., & Reis, A. M. M. (2014) Análise de um programa para otimização da transição do cuidado de pacientes em terapia antimicrobiana. Rev. APS.
Costa, R. S., Gabetto, R. S. de S., & Caribé, R. A. (2013). Análise farmacoeconômica de minimização de custos para protocolo de antibioticoterapia para pneumonia adquirida em comunidade de um hospital estadual do Rio de Janeiro/RJ. Rev. Bras. Farm. Hosp. Serv. Saúde.
Dubrovskaya, Y., Scipione, M. R., Siegfried, J., Jen, S. P., Pham, V., Papadopoulos, J., Decano, A., Lewis, T., & Dabestani, A. (2017) Multilayer Model of Pharmacy Participation in the Antimicrobial Stewardship Program at a Large Academic Medical Center. Hosp Pharm. 52(9):628-634.
Fernandes, I. de Q., Sousa, H. F. de, Brito, M. A. M., Tavares, S. N., Matos, V. C. de & Souza, M. de O. B (2012). Impacto farmacoeconômico da racionalização do uso de antimicrobianos em unidades de terapia intensiva. Rev Bras Farm Hosp Serv Saúde.
Grosbelli Vicari, N., Gonçalves de Oliveira, A., Ferrazzoli Devienne Vicentine, K., & Dias Paiva, A. (2020). Atividade Antimicrobiana Do Extrato De Casearia sylvestris CONTRA Enterococcus faecium Resistentes À Vancomicina. Revista Multidisciplinar Em Saúde, 1(2), 46.
Guillot, J., & Lebel, D. (2014). Usefulness of Defined Daily Dose and Days of Therapy in Pediatrics and Obstetrics-Gynecology: A Comparative Analysis of Antifungal Drugs (2000-2001, 2005-2006, and 2010-2011). J Pediatr Pharmacol Ther; 19(3):196-201.
Ibrahim, Mohammed, K. (2017). Design, synthesis, molecular modeling and antihyperglycemic evaluation of novel quinoxaline derivatives as potential PPARγ and SUR agonists. Bioorganic & Medicinal Chemistry, 25(4), 1496-1513.
Lobo, L. G., Ramos, F., Moretti, M. M., & Alves, P. H. (2017). Resultados de um Programa Multidisciplinar de Otimização do Uso de Antimicrobianos. R Epidemiol Control Infec; 7(1):47-51.
Momattin, H., Al-alib, A. Y., Mohammeda, K., Al-tawfiqc, J. (2018). Benchmarking of antibiotic usage: An adjustment to reflect antibioticstewardship program outcome in a hospital in Saudi Arabia. J Infect Public Health. 11(3):310-313.
Onzi, P. de S., Hoffman, S. P., & Camargo, A. L. (2011). Avaliação do consumo de antimicrobianos injetáveis de um hospital privado no ano de 2009. R. Bras. Farm. Hosp. Serv. Saúde 2(2):20-25.
Odorizzi, V. F. et al. (2017). Portadores assintomáticos de Staphylococcus aureus na cavidade nasal entre indígenas da etnia xerente, Tocantínia, Tocantins, Brasil. Anais do Seminário Científico do UNIFACIG, n. 2.
Polk, R. E., et al. (2007). Measurement of Adult Antibacterial Drug Use in 130 US Hospitals: Comparison of Defined Daily Dose and Days of Therapy. Clinical Infectious Diseases; 44(5):664-70
Rodrigues, F. A., & Bestoldi, A. D. (2010). Perfil da utilização de antimicrobianos em um hospital privado. Ciênc Saúde Coletiva; 15:1239-1247.
Santos Júnior, J. G. A. (2021). Desenvolvimento, caracterização e avaliação in vitro da atividade antibacteriana e formulações lipossomais. 73 f. Tese (Doutorado em Desenvolvimento e Inovação Tecnológica em Medicamentos) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2021.
Siegfried, J., Merchan, C., Scipione, M. R., Papadopoulos, J., Dabestani, A., & Dubrovskaya, Y. (2017). Role of postgraduate year 2 pharmacy residents in providing weekend antimicrobial stewardship coverage in an academic medical center. Am J Health Syst Pharm. 74(6):417-423
Sous, A. D. C. P., et al. (2014). Estudo da utilização do meropenem no hospital universitário alcides carneiro – HUAC. In: Congresso Brasileiro de Ciências da Saúde.
Scheetz, M. H., et al. (2016). Investigating the Extremes of Antibiotic Use with an Epidemiologic Framework. Antimicrob Agents Chemother; 60(6):3265-9
World Health Organization – WHO.(2012). The evolving threat of antimicrobial resistance options for action.
Wushouer, H., et al. (2017).Trends and patterns of antibiotic consumption in China's tertiary hospitals: Based on a 5 year surveillance with sales records, 2011-2015. PLoS ONE.
Vasconcelos, D. V., et al. (2015). O uso de antimicrobianos no âmbito hospitalar e as atribuições do farmacêutico na Comissão de Controle Infecção Hospitalar (CCIH). Rev Elet de Ciênc Hum, Saúde e Tecn.; 8(2).
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