Analysis of antimicrobial consumption and cost in a teaching hospital

The aim of this study is to compare the periods before and after the intervention applied using the ATC/DDD method in order to ascertain the rational use of antibiotics in a newly established hospital. The appropriateness of the hospital's antibiotic use, consumption rates and the costs were calculated and compared with other hospitals. Based on these data, an intervention has been planned in order to raise the quality of antibiotic use. The periods before and after the intervention were compared. Between 16 May 2011 and 23 May 2012, data were collected from all hospital units by the infectious diseases specialists and a point prevalence survey was conducted. Anatomical therapeutic chemical classification and the defined daily dose [DDD] methodology were used to calculate the antibiotic consumption. On two specific days in 2011 and 2012, 194 out of 307 patients [63.2%] and 224 out of 412 patients [54.4%] received antibiotic treatment, respectively. In 2011 and 2012, the percentage of appropriate antibiotic use was 51% and 64.3%, respectively. Both in 2011 and 2012, inappropriate antibiotic use was found to be significantly higher in surgical clinics in comparison to the internal diseases clinics and the ICU. This was caused by the high rates of inappropriate perioperative antimicrobial prophylaxis observed in surgical clinics. During both years, approximately one-third of the antibiotics were prescribed for the purposes of perioperative prophylaxis, while 88.5% and 43.7% of these, respectively, were inappropriate and unnecessary. Cephalosporins, fluoroquinolones, combinations of penicillins [including beta-lactamase inhibitors] and carbapenems were the most frequently prescribed antibiotics during the study periods. The mean total antibiotic consumption was 93.6 DDD/100 bed-days and 63.1 DDD/100 bed-days, respectively. The cost of total antibacterial consumption was euro 7901.33 for all the patients [euro 40.72 per infected patient] and euro 6500.26 [euro 29.01 per infected patient], respectively. Each hospital should follow and assess their antibiotic use expressed in DDD in order to compare their antibiotic use with national and international hospitals [WHO, 2009 [14]].

role of trace elements in helicobacter pylori infected patients

To evaluate the effect of trace elements in patients with Helicobacter pylori associated chronic gastritis. Prospective study. Clinical services of the clinical microbiology and infectious diseases and gastroenterology clinics at Dicle University, Turkey A total of 92 patients with variable severity of chronic gastritis [45 Helicobacter pylori positive and 47 Helicobacter pylori negative gastritis] and 90 age and sex matched healthy subjects were included in the study conducted between October 2006 and November 2008. Histopathologic examination, culture of Helicobacter pylori and urease tests were performed for each patient. The atomic absorption spectrophotometer was used in the measurement of trace elements in the serum. Serum copper and zinc levels were significantly elevated in patients with Helicobacter pylori associated gastritis compared to Helicobacter pylori negative gastritis and healthy controls [p < 0.0001]. Serum copper, zinc and Cu / Zn levels in patients with Helicobacter pylori negative chronic gastritis was not significantly different from the serum levels in healthy controls [p > 0.05]. Our results suggest a relationship between Helicobacter pylori associated chronic gastritis and the elevation of trace element levels in serum. This study confirms that the elevation of trace element levels in serum [Cu and Zn levels] will be helpful in the diagnosis of Helicobacter pylori associated chronic gastritis in the abscence of invasive procedures, and is useful in predicting the severity of infection in patients with chronic gastritis