Análisis minimizado de costes de antimicrobianos en un Centro de Salud / Minimised antimicrobial cost analysis at a Health Care Centre

El objetivo de este trabajo consiste en la valoración del coste de los antimicrobianos prescritos a pacientes adultos en un Centro de Salud y la búsqueda de alternativas para conseguir un ahorro en su uso. Para ello se llevó a cabo un estudio retrospectivo de la prescripción durante tres años con aplicación de un análisis minimizado de costes. La muestra quedó compuesta por 13.248 pacientes mayores de 14 años correspondientes al cupo de siete prescriptores Especialistas en Medicina Familiar y Comunitaria. El 46,06 por ciento de los individuos incluidos en el estudio sufrió alguna exposición a estos productos durante el período de estudio. Los antimicrobianos más utilizados fueron, por este orden, asociaciones de antibióticos, penicilinas, macrólidos, cefalosporinas y quinolonas. Respecto al coste (135.846, 77 €), los grupos que más contribuyeron al mismo fueron los macrólidos, asociaciones de antibióticos, cefalosporinas, quinolonas y penicilinas, que supusieron el 82,60 por ciento de dicho coste. Si se hubiera realizado la prescripción de las especialidades farmacéuticas más baratas existentes en el mercado, se hubiera ahorrado un 7,22 por ciento del coste total (9.813,51 €) (AU)

The aim of this study is to assess the economic cost of the antimicrobials prescribed to adult patients at a health centre as well as to search for some cheaper alternatives. A retrospective study was carried out. The economic cost of antimicrobial agents prescribed over three years was studied. Afterwards, a minimized analysis of costs was made. The final sample was formed by 13248 people all of them older than 14 years, who were attended bay seven practitioners. During the study period, antimicrobials were prescribed to the 40.06% of these patients, The most commonly used groups were antibiotic combinations, penicillins, macrolides, cephalosporins and quinolones in this order. The total expenditure reached 135846.7 7 €. The most important groups from an economic point of view were macrolides, antibiotic combinations, cephaloSporins, quinolones and penicillins (82.60% of the total expenditure). By prescribing the cheapest marketed pharmaceutical products a 7.22% (9813.51 €) of the total expenditure could have been saved (AU)

Trends in antimicrobial utilization at a Spanish general hospital during a 5-year period.

PURPOSE: Antimicrobials are a major part of hospital pharmacy budgets and must be considered in resource planning and spending projections. This study describes the profile of antibiotic use at a medium-sized hospital (by examining the ICU separately) and analyses its evolution over the period 1996-2000. METHODS: Descriptive and retrospective study. Pharmacy records were reviewed to identify oral and parenteral antimicrobial agents administered to inpatients. Results were expressed in Daily Defined Doses (DDD) per 100 stays and day. RESULTS: During the 5-year study period 176.162 DDD/100 s-d of antibiotics were consumed in the ICU, whereas in the rest of the hospital usage was much lower (54.438 DDD/100 s-d). Aminoglycosides, cephalosporins, penicillins, glycopeptides and carbapenems were the most commonly used groups of antimicrobials in the ICU, and penicillins, cephalosporins, trimethoprim/sulfonamide combinations, aminoglycosides and quinolones in the rest of the hospital. CONCLUSIONS: ICUs have some special features which make them different to the other inpatient areas. Because of that fact we consider it important to study this specific patient-care area separately.

Prescripción de antimicrobianos en adultos en una zona rural / Antimicrobian prescription for adults in a rural area

La utilización de antimicrobianos es especialmente importante en la sociedad por la elevada incidencia de enfermedades infecciosas y porque su uso abusivo contribuye al desarrollo de resistencias. Objetivo: Estudiar la prescripción de antimicrobianos en la edad adulta en un núcleo rural. Método: Estudio retrospectivo. Se valoró el empleo de antimicrobianos durante un período de 18 meses mediante la revisión de las historias clínicas de los pacientes que conformaron la muestra a estudiar (n = 800). Resultados: Al 45,63 por ciento de la muestra le fue pautado algún antimicrobiano, existiendo diferencias estadísticamente significativas a favor de las mujeres. Los subgrupos más prescritos fueron las asociaciones de antibióticos, las penicilinas, los macrólidos, las cefalosporinas y las quinolonas, por este orden. Los principios activos más empleados fueron la asociación amoxicilina - ácido clavulánico, amoxicilina, claritromicina, cefuroxima axetilo y norfloxacino, respectivamente. A los hombres se les prescriben más macrólidos que a las mujeres y a éstas más quinolonas, particularmente norfloxacino. Se observa una significativa tendencia al aumento de la prescripción de este tipo de fármacos con la edad. Conclusiones: La elevada utilización de los agentes antimicrobianos obliga a promover un empleo más racional de los mismos, por ello consideramos importante la realización de este tipo de estudios con el fin de valorar su evolución (AU)

The high incidence of infectious diseases and the development of bacterial resistances, as a consequence of the abusive consumption of antibiotics, emphasize the importance of controlling the use of this type of drugs. Objective: To study the prescription of antibiotics among adult people in a rural area. Method: A retrospective study. The use of antimicrobial agents during [8 months was evaluated by reviewing the clinic histories of those patients previously selected for the study (n = 800). Main results: The 45,63% of the patients had at least one type of antimicrobial during the period of study. The prescription of this type of drugs was signficantly higher among women but for both sexes, it increases significantly with age. Associations of antibiotics, penicillins, macrolides, cephalosporins and quinolones were, in this order, the most utilized groups of antimicrobial drugs. Amoxycillin - clavulanic acid, amoxycillin, clarithromycin, cefuroxime and norfloxacin were, respectively, the most prescribed drugs. The prescription of macrolides is significantly higher among men whereas quinolones, and particularly norfloxacin, are more used by women. Conclusions: Antibiotics should be utilized in a rational way, however the current consumption existing in our society is excessive. We consider that this kind of studies should be promoted to control and to evaluate how the use of these drugs evolves with time (AU)