Jachowicz Estera, Różańska Anna, Pobiega Monika, Topolski Mariusz, Wójkowska-Mach Jadwiga
Department of Microbiology, Faculty of Medicine, Jagiellonian University Collegium Medicum, 31-121 Kraków, Poland.
Department of Systems and Computer Networks, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland.
Antibiotics (Basel). 2020 Mar 19;9(3):127. doi: 10.3390/antibiotics9030127.
The most important pathomechanism of infections (CDI) is post-antibiotic intestinal dysbiosis. CDI affects both ambulatory and hospital patients.
The objective of the study was to analyze the possibility of utilizing databases from the European Centre for Disease Prevention and Control subject to surveillance for the purpose of identifying areas that require intervention with respect to public health.
The analysis encompassed data concerning CDI incidence and antibiotic consumption expressed as defined daily doses (DDD) and quality indicators for antimicrobial-consumption involving both ambulatory and hospital patients in 2016.
In 2016, in the European Union countries, total antibiotic consumption in hospital and outpatient treatment amounted to 20.4 DDD (SD 7.89, range 11.04-39.69); in ambulatory treatment using average of ten times more antibiotics than hospitals. In total, 44.9% of antibiotics used in outpatient procedures were broad-spectrum antibiotics. We have found a significant relationship between the quality of antibiotics and their consumption: The more broad-spectrum antibiotics prescribed, the higher the sales of antibiotics both in the community sector and in total. CDI incidence did not statistically significantly correlate with the remaining factors analyzed on a country-wide level.
Antibiotic consumption and the CDI incidence may depend on many national variables associated with local systems of healthcare organization and financing. Their interpretation in international comparisons does not give clear-cut answers and requires caution.
艰难梭菌感染（CDI）最重要的发病机制是抗生素相关性肠道菌群失调。CDI影响门诊患者和住院患者。
本研究的目的是分析利用欧洲疾病预防控制中心监测数据库来确定需要进行公共卫生干预领域的可能性。
分析涵盖了2016年门诊和住院患者中与CDI发病率、以限定日剂量（DDD）表示的抗生素消耗量以及抗菌药物消耗质量指标相关的数据。
2016年，在欧盟国家，医院和门诊治疗中的抗生素总消耗量为20.4 DDD（标准差7.89，范围11.04 - 39.69）；门诊治疗中使用的抗生素平均比医院多十倍。门诊手术中使用的抗生素有44.9%是广谱抗生素。我们发现抗生素质量与其消耗量之间存在显著关系：开具的广谱抗生素越多，社区部门和总体的抗生素销售额就越高。在全国范围内，CDI发病率与分析的其他因素没有统计学上的显著相关性。
抗生素消耗量和CDI发病率可能取决于许多与当地医疗保健组织和融资系统相关的国家变量。在国际比较中对它们的解读并不能给出明确答案，需要谨慎对待。
