Evaluation of Rational Use of Antibacterial Drugs

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Abstract

Backgraund. WHO considers the problem of antimicrobial resistance to be the serious threat to humanity. One approach to solve it is to restrict the use of antimicrobials. This approach implies the implementation of educational programs. Such programmes take much time and money. However, the effectiveness of educational programs is not clear. 

Aims: determine the effectiveness of educational activities in the field of rationalization of the use of antibacterial drugs. 

Materials and methods. Two-stage multicenter research on the practice of antibacterial drugs application and the effectiveness of educational programs designed to rationalize antibiotic therapy in Primorsky Territory. 

Results. It was found that programs aimed only at the training of doctors are ineffective. The frequency of unjustified use of antimicrobials remains high — 72.7% (2002−2003) and 70.4% (2011−2012). 

Conclusion. To improve the rationality of medical prescriptions (antibacterial drugs) it is necessary to combine educational programs with management measures.

 

About the authors

Yuliya Igorevna Gaynullina

Far Eastern Federal University

Author for correspondence.
Email: yuliadoc12.y@yandex.ru
MD, PhD, Assistance professor Russian Federation

References

  1. Щепин ОП, Белов ВБ, Роговина АГ. Современная медико-демографическая ситуация в России. Проблемы социальной гигиены, здравоохранения и истории медицины. 2009;6:3–8.
  2. World Health Organization Antimicrobial resistance: global report on surveillance 2014; 234 p. URL:http://apps.who.int/iris/bitstream/10665/112642/1/9789241564748_eng.pdf?ua=1 (Available: 22.11.2015).
  3. Арепьева МА, Колбин АС, Курылев АА, Балыкина ЮЕ, Сидоренко СВ. Систематический обзор математических моделей, применяемых для прогнозирования развития резистентности бактерий к антибиотикам. Клиническая микробиология и антимикробная химиотерапия. 2014;16(2):137–143.
  4. Davey P, Brown E, Charani E, Fenelon L, Gould IM, Holmes A, Ramsay CR, Wiffen PJ, Wilcox M. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev. 2013;4:CD003543.
  5. WHO global strategy for containment of antimicrobial resistance, 2001. World Health Organization. URL:http://www.who.int/drugresistance/execsumR.pdf. (Available: 22.11.2015).
  6. Prudent use of antimicrobial agents in human medicine. URL:http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=URISERV:c11569 (Available: 22.11.2015).
  7. Barnett ML, Linder JA. Antibiotic prescribing for adults with acute bronchitis in the United States, 1996-2010. JAMA. 2014;311(19):2020–2022. doi: 10.1001/jama.2013.286141
  8. Putnam LR, Chang CM, Rogers NB, Podolnick JM, Sakhuja S, Matusczcak M. et al. Adherence to surgical antibiotic prophylaxis remains a challenge despite multifaceted interventions. Surgery. 2015;158(2):413–419. doi: 10.1016/j.surg.2015.04.013
  9. Kronman MP., Zhou C., Mangione-Smith R. Bacterial prevalence and antimicrobial prescribing trends for acute respiratory tract infections. Pediatrics. 2014;134(4):956–965. doi: 10.1542/peds.2014-0605
  10. Красножон ТВ, Дьяченко СВ, Адаев АМ, Бондаренко ОА. Фармакоэпидемиологический анализ использования антимикробных препаратов в многопрофильном хирургическом стационаре. Вестник общественного здоровья и здравоохранения Дальнего востока России. 2013;3:118–121.
  11. Togoobaatar G, Ikeda N, Ali M, Sonomjamts M, Dashdemberel S, Mori R, Shibuya K. Survey of non-prescribed use of antibiotics for children in an urban community in Mongolia. Bull World Health Organ. 2010;88:930–936. doi: 10.2471/BLT.10.079004
  12. Yin X, Song F, Gong Y, Tu X, Wang Y, Cao S. et al. A systematic review of antibiotic utilization in China. J Antimicrob Chemother. 2013;68(11):2445–2452. doi: 10.1093/jac/dkt223.
  13. Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery ASHP Therapeutic Guidelines American Society of Health System Pharmacists 2013. Р. 582–666. URL: http://www.ashp.org/surgical-guidelines (Available: 22.11.2015).
  14. Togo Y, Taoka R, Yamamoto S, Hiyama Y, Uehara T, Hashimoto J. et al. A questionnaire Survey of Antimicrobial Prophylaxis to Prevent Perioperative Infection in Urological Field in Japan. Japanese Journal of Urology. 2013;104(4):579–588. doi: 10.5980/jpnjurol.104.579
  15. Ozgun H, Ertugrul BM, Soyder A, Ozturk B, Aydemir M. Peri-operative antibiotic prophylaxis: adherence to guidelines and effects of educational intervention. Int J Surg. 2010;8(2):159–163. doi: 10.1016/j.ijsu.2009.12.005
  16. Classen D, Evans R, Pestotnik S, Horn S, Menlove R, Burke J. The timing of prophylactic administration of antibiotics and the risk of surgical infection N Engl J Med. 1992;326:281–286. doi: 10.1056/NEJM199201303260501
  17. Nelson RL, Glenny AM, Song F. Antimicrobial prophylaxis for colorectal surgery. Cochrane Database Syst Rev. 2009;1:CD001181. doi: 10.1002/14651858.CD001181.pub3.
  18. Tourmousoglou CE, Yiannakopoulou ECh, Kalapothaki VC, Bramis JJ. Papadopoulos St. Adherence to guidelines for antibiotic prophylaxis in general surgery: a critical appraisal. J Antimicrob Chemotherapy. 2008;61(1):214–218. doi: 10.1093/jac/dkm406
  19. Bratzler DW, Houck PM, Richards C, Steele L, Dellinger EP, Fry DE. et al. Use of antimicrobial prophylaxis for major surgery: baseline results from the National Surgical Infection Prevention Project. Arch Surg. 2005;140(2):174–182. doi: 10.1001/archsurg.140.2.174
  20. Плешков ВГ, Голуб АВ, Москалев АП. Галкин Д.В., Козлов Р.С. Антибактериальная профилактика и качество ее проведения в абдоминальной хирургии. Инфекции в хирургии. 2007;5(2):21–28.
  21. Abdel-Aziz A, El-Menyar A, Al-Thani H, Zarour A, Parchani A, Asim M. et al. Adherence of surgeons to antimicrobial prophylaxis guidelines in a tertiary general hospital in a rapidly developing country. Adv Pharmacol Sci. 2013;2013:842593. doi: 10.1155/2013/842593.
  22. Ackerman SL, Gonzales R, Stahl MS, Metlay JP. One size does not fit all: evaluating an intervention to reduce antibiotic prescribing for acute bronchitis. BMC Health Serv Res. 2013;13:462. doi: 10.1186/1472-6963-13-462
  23. Lalana-Josa P, Laclaustra-Mendizábal B, Aza-Pascual-Salcedo MM, Carcas-de-Benavides C, Lallana-Álvarez MJ, Pina-Gadea MB. Does the prescribing of antibiotics in paediatrics improve after a multidisciplinary intervention? Enferm Infecc Microbiol Clin. 2015;33(2):78–83. doi: 10.1016/j.eimc.2014.05.017.
  24. Khan SA, Rodrigues G, Kumar P, Rao PG. Current challenges in adherence to clinical guidelines for antibiotic prophylaxis in surgery. J Coll Physicians Surg Pak. 2006;16(6):435–437. doi:6.2006/JCPSP.435437.
  25. Индейкин ЕН. Место практических рекомендаций в системе управления качеством медицинской помощи. Вопросы экспертизы и качества медицинской помощи. 2009;5:8–12.
  26. Fridkin S, Baggs J, Fagan R, Magill S, Pollack LA, Malpiedi P. et al. Vital signs: improving antibiotic use among hospitalized patients. MMWR Morb Mortal Wkly Rep. 2014;63(9):194–200.
  27. O’Reilly M, Talsma A, VanRiper S, Kheterpal S, Burney R. An anesthesia information system designed to provide physician-specific feedback improves timely administration of prophylactic antibiotics. Anesth Analg. 2006;103(4):908–912. doi: 10.1213/01.ane.0000237272.77090.a2
  28. Ozkurt Z, Erol S, Kadanali A, Ertek M, Ozden K, Tasyaran MA. Changes in antibiotic use, cost and consumption after an antibiotic restriction policy applied by infectious disease specialists. Jpn J Infect Dis. 2005;58(6):338–343.
  29. Arnold SR, Straus SE. Interventions to improve antibiotic prescribing practices in ambulatory care. Cochrane Database Syst Rev. 2005;4:CD003539. doi: 10.1002/14651858.CD003539.pub2
  30. Гончаров НГ, Воробьёв ПА, Авксентьева МВ, Оранская ОВ, Акимова ОС, Лукьянцева ДВ, Тюрина ИВ. Создание системы управления качеством в центральной клинической больнице Российской академии наук. Проблемы стандартизации в здравоохранении. 2008;4:3–7.

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