Application of ATC/DDD methodology to analyse antibiotic consumption in internal medicine department: A review
DOI:
https://doi.org/10.46542/pe.2023.234.251258Keywords:
Antibiotic, ATC/DDD, Consumption, Defined Daily Dose, Internal medicineAbstract
Background: Antibiotic resistance has become a significant problem due to its impact such as higher medical costs, prolonged hospital stays, and increased mortality. The Internal Medicine Ward has a high consumption of antibiotics, particularly for gastroenteritis, typhoid, diabetic ulcer, urinary tract infection, and sepsis. The DDD/ATC systems applied in hospitals may provide valid data to evaluate antimicrobial usage as a global standard method.
Objective: To explore the antibiotic use pattern in the internal medicine department based on the DDD/ATC system.
Method: The authors explored articles from the database in PMC, Research Gate, and Google Scholar from July 11st, 2020, to July 21st, 2020. The authors included original articles/research, case reports, and meta-analyses from 2006 to 2020, which discussed DDD/100 patient-days or DDD/100 bed-days antibiotics in the internal medicine ward. A major criterion was to ensure all subjects in publications were adults aged above 18.
Result: Penicillin is the most consumed (127.9 DDD/100 bed-days), followed by Cephalosporin (41.42 DDD/100-bed-days) and Fluoroquinolone (25.87 DDD/100 bed-days).
Conclusion: The most widespread antibiotic use in Internal Medicine in many countries showed an improvement in rational antibiotic consumption.
References
Acharya, K. P., & Wilson, R. T. (2019). Antimicrobial Resistance in Nepal. Frontiers in Medicine, 5, 7–9. https://www.doi.org/10.3389/fmed2019.00105
Alberto, F., Antonio, F., Massimo, D. P., Chiara, C., Giovanna, M., Costanza, B., Sara, B., & Lorendana, R. (2018). Antimicrobial stewardship in an Internal Medicine ward: Effects on antibiotic consumption and the use of carbapenems. Internal and Emergency Medicine, 1–8. https://www.doi.org/10.1007/s11739-018-1916-9
Alberto, V., Maria, C. S., Laura, B., Domenico, M., Petar, S., Antonio, V., Elisabetta, P., & Nicol, A. M. (2018). Journal of Antimicrobial Chemotherapy, 61(4), 953–958. https://www.doi.org/10.1093/jac/dkn010
Ann, V., Peter, Z., Isabelle, C., Marie, F. G., Nico, D., Mark, M., Vincent, J., Dilip, N., & Herman, G. (2018). Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries: Results of an internet-based global point prevalence survey. The Lancet Global Health, 6(6), 619–629. https://www.doi.org/10.1016/S2214109X(18) 30186-4
Begum, T., Parveen, F., Khan, I., Ara, F., Shana, R., & Iqbal, J. (2010). Measurement of Antibiotic Utilization in the Internal Medicine Ward of a Tertiary Hospital in Bangladesh. Bangladesh Medical Journal, 39(2), 11–15. https://www.doi.org/10.3329/bmj.v39i2.7030
Bolla, C., Di, Pietrantonj, C., Ferrando, E., Pernecco, A., Salerno, A., D’Orsi, M., & Chichino, G. (2019). Example of an antimicrobial stewardship program in a community hospital in Italy. Medecine et Maladies Infectieuses, 50(4), 342–345.
Brayfield, A. (2014). Martindale: The Complete Drug Reference 38th edition. Pharmaceutical Press, 162–387.
CDC. (2019). Antibiotic Resistance in the United States. https://www.cdc.gov/drugresistance/biggestthreats. html
CDC. (2021). Antibiotic Resistance in the United States. https://www.cdc.gov/drugresistance/biggest-threats.html
Deck, D. H., & Winston, L. G., (2012). Aminoglycoside & Spectinomycin. In G. Katzung, B. Masters, J. Trevor New York: McGraw-Hill Companies, 821—829.
Deck, D. H., & Winston, L. G. (2012). Beta-Lactam & Other Cell Wall- & Membrane-Active Antibiotics. In: G. Katzung, B. Masters. J. Trevor, Basic & Clinical Pharmacology. New York: McGraw-Hill Companies, 790-808
Deck, D. H., & Winston, L. G. (2012). Sulfonamides, Trimethoprim, & Quinolones. In: G. Katzung, B. Masters, J. Trevor 12th edition. New York: McGraw-Hill Companies, 831–838.
Deck, D. H., & Winston, L. G. (2012). Tetracyclines, Macrolides, Clindamycin, Chloramphenicol, Streptogramins, & Oxazolidinones. In: G. Katzung, B. Masters, J. Trevor 12th edition. New York: McGraw-Hill Companies, 809–19 https://www.doi.org/10.1016/j.medmal.2019. 11.008
Elena, B., Chiara, B., Mauro, M., Rosalia, L., Domenico, M., & Alberto, V. (2014). Use of antibacterial agents in Italian hospitals: A 2004 to 2011 drug utilization survey in the Emilia-Romagna region. Expert Review of Anti-Infective Therapy, 12(3), 383–92 https://www.doi.org/10.1586/147872 10.2014.884459
Fatma, B., Safak, K., Recep, T., Serda, G., Ozcan, D., Saim, D., & Salih, H. (2014). Analysis of antimicrobial consumption and cost in a teaching hospital. Journal of Infection and Public Health, 7(2), 161–169. https://www.doi.org/10.1016/j.jiph.2013 .09.007
Girma, G., Helle, H., Ephrem, E., & Else, L. T. (2018). Multiple challenges of antibiotic use in a large hospital in Ethiopia - A ward-specific study showing high rates of hospital-acquired infections and ineffective prophylaxis. BMC Health Services Research, 18(1), 1–7. https://www.doi.org/10.1186/ s12913-018-3107-9
Hamdi, S., Ibak, G., Ayse, S., Ali, K., Serdar, K., & Murat, S. (2013). Application of ATC/DDD methodology to evaluate of antibiotic use in a general hospital in Turkey. Annals of Clinical Microbiology and Antimicrobials, 12(1), 1–7. https://www.doi.org/10.1186/1476-0711-1223
Itamar, S., Marcelo, L., Erez, L., Michal, C., Oren, Z., Klaris, R., Jihad, B., & Rau, R. (2008). Antibiotic use in 26 departments of internal medicine in 6 general hospitals in Israel: Variability and contributing factors. Journal of Antimicrobial Chemotherapy, 62(1), 196–204. https://www.doi.org/10.1093/jac/dkn150
Joint Formulary Committee. (2019). British National Formulary 78th edition. London: Pharmaceutical Press.
Joint Formulary Committee. (2020). British National Formulary 79th edition. London: Pharmaceutical Press.
Kementerian Kesehatan Republik Indonesia. (2011). Pedoman Pelayanan Kefarmasian Untuk Terapi Antibiotika Kementrian Kesehatan Republik Indonesia. Direktorat Jenderal Bina Kefarmasian dan Alat Kesehatan.
Kementerian Kesehatan Republik Indonesia. (2011). Pedoman Umum Penggunaan Antibiotik. Kementrian Kesehatan Republik Indonesia.
Kuster, S. P., Ruef, C., Ledergerber, B., Hintermann, A., Deplazes, C., Neuber, L., & Weber, R. (2008). Quantitative antibiotic use in hospitals: Comparison of measurements, literature review, and recommendations for a Standard of Reporting. Infection, 36(6), 549–59. https://www.doi.org/10.1007/s15010-008-7462-z
MacDougall. (2018). Aminoglycosides. In: L. Brunton, R.Hilal-Dandan, C. Knollmann. Goodman & Gilman’s The Pharmacological Basis of Therapeutics 13th ed. New York: McGraw-Hill Companies, 1039–1047.
MacDougall. (2018). Aminoglycosides. In: L. Brunton, R.Hilal-Dandan, C. Knollmann. Goodman & Gilman’s The Pharmacological Basis of Therapeutics 13th ed (pp. 1049–1065). New York: McGraw-Hill Companies,.
MacDougall (2018). Penicillins, Cephalosporins, and Other ß-Lactam Antibiotics. In L. Brunton, R.Hilal-Dandan, C. Knollmann, Goodman & Gilman’s The Pharmacological Basis of Therapeutics 13th ed (pp. 1023–38). New York: McGraw-Hill Companies. 2018.
MacDougall. (2018). Sulfonamides, Trimethoprim-Sulfamethoxazole, Quinolones, and Agents for Urinary Tract Infection. In: L. Brunton, R.Hilal-Dandan, C. Knollmann. Goodman & Gilman’s The Pharmacological Basis of Therapeutics 13th ed (pp. 1011–1021). New York: McGraw-Hill Companies.
National Institute for Health and Care Excellence. (2018). NICE impacts antimicrobial resistance. https://www.nice.org.uk/
Nebyu, D. A., Dawit, G. W., & Yohana, H. B. (2020). Antibiotic consumption study in two hospitals in Asmara from 2014 to 2018 using WHO’s defined daily dose (DDD) methodology. PloS One, 15(7), 1–11. https://www.doi.org/10.1371/journal.pone.0233275
OECD. (2018) Stemming the superbug tide. https://www.doi.org/10.1787/9789264307599-en
Shankar, P. R., Partha, P., Dubey, A. K., Upadhyay, D. K. & Mishra, P. (2006). Drug Utilisation in Medical Inpatients. Journal of Nepal Health Research Council, 4(1), 1–8.
Siswandono. (2016). Kimia Medisinal Jilid 2 (2nd ed.). Airlangga University Press.
Sweileh, W. M., Sawalha, A. F., Abed, R. M. A., & Rabba, A. K. (2007). Utilization of anti-infective agents measured in “Defined Daily Dose” (DDD): A study in Palestine. The Islamic University Journal, 15(2), 59–66.
Usman, H., Duerink, D. O., Lestari, E. S., Nagelkerke, N. J., Keuter, M., Huis, I. V. D., Suwandojo, E., Rahardjo, E., Van, D. B. P., & Gyssens, I. C. (2008). Audit of antibiotic prescribing in two governmental teaching hospitals in Indonesia. Clinical Microbiology and Infection, 14(7), 698–707 https://www.doi.org/10.1111/j.1469-0691.2008.02014.x
Usman, H., Kuntaman, K., Qibtiyah, M., & Paraton, H. (2013). The Problem of Antibiotic Use and Antimicrobial Resistance in Indonesia: Are We Really Making Progress? Indonesian Journal of Tropical and Infectious Disease, 4(4), 1–5. https://www.doi.org/10.20473/ijtid.v4i4.222
Usman, H., Monique, K., Henri, V. A., & Peterhans, V. D. B. (2008). Optimising antibiotic usage in adults admitted with fever by a multifaceted intervention in an Indonesian governmental hospital. Tropical Medicine and International Health, 13(7), 888–899. https://www.doi.org/10.1111/j.1365-3156.2008.02080.x
World Health Organisation Collaborating Centre for Drug Statistics Methodology. (2019). Guidelines form ATC classification and DDD assignment. Norway: Norwegia Institute of Public Health.
World Health Organisation. (2015). Global action plan on antimicrobial resistance, 1–28
World Health Organisation. (2018). Antimicrobial resistance. https://www.who.int/news-room/fact-sheets/detail/antimicrobialresistance
World Health Organisation. (2019). Antibiotics resistance. https://www.who.int/news-room/fact-sheets/detail/antibiotikresistance
World Health Organisation. (2019). Antimicrobial stewardship programmes in health-care facilities in low- and middle-income countries: A WHO practical toolkit. In JAC-Antimicrobial Resistance, 1(3), 1–2. https://www.doi.org/10.1093/jacamr/dlz072
World Health Organisation. (2019). Infectious disease. https://www.who.int/topics/infectious _diseases/en/
World Health Organisation. (2019). New report calls for urgent action to alert antimicrobial resistance crisis.
World Health Organisation. (2019). World Health Organization model list of essential medicines. Mental and Holistic Health: Some International Perspectives, 21(1), 119–134.
