Antimicrobial consumption in a hospital environment before and after restrictive commercialization measures in Brazil

J. S. Malta, Cristiane Aparecida Menezes Pádua, Leandro Pinheiro Cintra, Carla Jorge Machado, Josiane Moreira da Costa, Andréia Queiroz Ribeiro
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Abstract

Introduction: The consumption of antimicrobials (ATB) has been described as one of the causes of Bacterial Resistance. In 2010, RDC 44 was published in Brazil, which restricts the free sale of ATB to reduce antimicrobial resistance in hospitals. Aim: to identify the consumption of ATB in a teaching hospital before and after the implementation of the restrictive measure on the commercialization of antimicrobials in Brazil. Outlining: Cross sectional study carried out in a general hospital. Analyzes were carried out in two phases, using the variables ATB consumption, expressed in defined daily dose (DDD), average use of different ATB per patient and the frequency of resistant microorganisms in the period. Results: The average use of ATB per patient was 2.56 (Standard Deviation (SD) ± 2.02) and2.40 (SD ± 1.89) in phases I and II, respectively (p=0.0007). The general variation in defined daily dose was 1.89%, however drugs with negative variation were observed. A higher frequency of resistant microorganisms isolated in phase I was observed compared to phase II (OR=1.48, CI: 1.13-1.93, respectively). Implications: A difference was identified in the consumption of ATB between the periods, with an increase in general consumption, in DDD, but a lower average number of different ATBs per patient and a lower occurrence of resistant microorganisms. 
巴西采取限制性商业化措施前后医院环境中的抗菌药消耗量
导言:抗菌药(ATB)的使用被认为是导致细菌耐药性的原因之一。2010 年,巴西发布了 RDC 44,限制抗菌药物的自由销售,以减少医院中的抗菌药物耐药性。目的:确定巴西实施抗菌药物商业化限制措施前后一家教学医院的抗菌药物消耗量。概述:在一家综合医院开展的横断面研究。分析分两个阶段进行,使用的变量包括:以规定日剂量(DDD)表示的ATB消耗量、每位患者平均使用不同ATB的情况以及在此期间出现耐药微生物的频率。结果显示在第一和第二阶段,每位患者平均使用的 ATB 分别为 2.56(标准差(SD)±2.02)和 2.40(SD±1.89)(P=0.0007)。规定日剂量的总体变化率为 1.89%,但也观察到了负变化的药物。与第二阶段相比,第一阶段分离到的耐药微生物频率更高(OR=1.48,CI:分别为 1.13-1.93)。影响:研究发现,不同时期的ATB消耗量存在差异,DDD的总体消耗量有所增加,但每位患者平均使用不同ATB的数量较少,耐药微生物的发生率也较低。
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