A six-year evaluation of antibiotics consumption in the defined daily doses in the septic orthopedic-traumatology department

Abstract

Background: Septic orthopedic and traumatology treatment permanently required a great spectrum of antibiotics to be used. Evaluation of consumption in defined daily doses is one of principal methods for improving rational usage and good planning of hospitals’ necessities of antiinfectives for systemic use. Material and methods: For this study we used data of a six-year (2009-2014) period, in septic orthopedic-traumotology department of the Emergency Medicine Institute, which show the consumption dynamics of anti-infectives for systemic use of drugs in grams and value indexes. Results: The defined daily doses (DDD)/1000 occupied-bed days (OBD) of antibiotics in septic orthopedic-traumotology department from 578 in 2009 increased to 675 in 2014 or by 16.78% and is 14.05% lower than medium consumption of 769.83 in 152 international hospitals with the similar activity. The value of 5741 lei per DDD/1000 OBD in 2009 recorded a slow decline to 5447 lei or by 5.12%. The cost of one medium DDD from 9.94 lei in 2009 decreased to 8.07 lei in 2014 or 18.81%. The rate of anti-infectives for systemic use in 2014 presented 50169.00 lei or a share of 32% from the total departmental value of consumption; the same data in 2009 were 78054.84 lei or 34.75%. The share from the total antibiotics institutional consumption in 2014 was recorded 3.34% and 5.00% in 2009 respectively. The average antibiotics annual institution consumption constituting 464.1 in 2014 is higher by 1.06% comparatively with medium consumption of 459.20 registered in 1706 international hospitals, and by 35.31% in comparison with global consumption of 343 defined daily doses per 1000 patient-days. Conclusions: The increase of DDD/1000 OBD took place as a result of worldwide increasing pathogenic microbes resistance to antibiotics. Nevertheless, decrease value indexes and cost of one DDD show in the best way the capacity of departmental management to cope with institutional budget deficiency and maintain qualitative antimicrobial treatment of hospitalized patients.