Establishment of the multidisciplinary Committee for Control and Prevention of Infections as key factor for the rationalization of antibiotic utilization in Clinical Hospital Acibadem Sistina-Skopje

Abstract

Antibiotics are indicated in the prevention and treatment of bacterial infections. Antibiotic resistance is a global healthcare problem, strongly connected to hospital-acquired infections. As drug resistance is world-wild problem new educational programs and prescribing and utilization strategies should be developed. Evaluation of the implementation of the measures by Committee for control and prevention of infections at Clinical Hospital Acibadem Sistina-Skopje and assessment of its function in the monitoring of the level of infections and rationalization in antibiotics prescription in hospitalized patients. Isolates taken from patients in the Clinical Hospital Acibadem Sistina-Skopje were used in this study. Monthly and annual analysis was performed by pharmacist for a controlled group of antibiotics prescribed based on obtained antibiogram results confirmed by a microbiologist.The Committee for Control and Prevention of Infections also monitors the consumption of antibiotics on a monthly and annual basis calculated through the list of published antibiotics in defined daily doses (DDD-Defined daily doses) per 1000 hospital days. Obtained results present that consumption of controlled antibiotics is stable in the evaluated period with a tendency of declination. They are used in indicated patients with the exception of Imipenem/Cilastatin. The evaluation of previously applied to proscribe routine for this combined antibiotic suggested that the patients were sub-dosed. The applied measure resulted in rational and appropriate dosing of the patients and coherent increased consumption of Imipenem/Cilastatin. The second measure applied was associated with the rationalization of surgical profilaxis and substitution of ceftriaxone with cefazolin. The costs in 2016 were 12 421 100 MKD (201 969 Eur), compared to the expenditures in 2017 of 11 891 000 MKD. (193 349 Eur). Implementation of appropriate measures by establishment of the Committee led to the reduction of irrational antibiotics utilization and decrease of the antibiotics associated expenditure in the Clinical Hospital Acibadem Sistina. Keywords: antibiotics, antibiotic resistance, rational antibiotic utilization, expenditures