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加纳的抗生素消费趋势:对一家二级医疗机构六年药房配药数据的分析。

Antibiotic consumption trends in Ghana: analysis of six-years pharmacy issue data from a secondary healthcare facility.

作者信息

Labi Appiah-Korang, Kartey Bridget S, Hedidor George Kwesi, Nuertey Benjamin Demah, Kodjoe Elsie, Vanderpuije Leslie No, Obeng-Nkrumah Noah

机构信息

Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana.

Life Course Cluster, WHO Ghana Country Office, No. 7 Ameda Street, Roman Ridge, Accra, Ghana.

出版信息

JAC Antimicrob Resist. 2023 Mar 21;5(2):dlad025. doi: 10.1093/jacamr/dlad025. eCollection 2023 Apr.

Abstract

BACKGROUND

Surveillance of hospital antibiotic consumption provides data to inform corrective action and for monitoring antimicrobial stewardship activities. This study described antibiotic consumption patterns from 2016 through 2021 at a secondary healthcare facility in Ghana.

METHODS

Using the WHO methodology for surveillance of antimicrobial consumption in hospitals, we analysed a 6-year pharmacy issue data at the Eastern Regional Hospital. We report on the defined daily dose (DDD) per 100 patients, types of antibiotics consumed according to Anatomic Therapeutic Classification (ATC), WHO AWaRe classification; trends in antibiotic consumption and expenditure per DDD of antibiotics consumed.

RESULTS

Over the period, the mean (±standard deviation) antibiotic consumption rate was 256.7 ± 33 DDD/100 patients per year. A linear regression model showed an insignificant decreasing trend in antibiotic consumption (coefficient for time -0.561;  = 0.247). The top three consumed antibiotics in DDD/100 patients at ATC level 5 were amoxicillin-clavulanate ( = 372.6), cefuroxime ( = 287.4) and sulfamethoxazole-trimethoprim ( = 145.8). The yearly Access-to-Watch ratio decreased from 2.4 in 2016 to 1.2 in 2021. The mean yearly cost of antibiotics was $394 206 ± 57 618 US dollars. The top three antibiotics consumed in terms of cost were clindamycin $718 366.3, amoxicillin-clavulanate $650 928.3 and ceftriaxone $283 648.5.

CONCLUSION

This study showed a sturdy rate of antibiotic consumption over the 6-year period with a year-on-year decrease in the Access-to-Watch antibiotic ratio. Data from pharmacy drug issues offer an opportunity to conduct antibiotic consumption surveillance at the hospital and national level in Ghana.

摘要

背景

监测医院抗生素使用情况可提供数据,以指导采取纠正措施并监测抗菌药物管理活动。本研究描述了2016年至2021年加纳一家二级医疗机构的抗生素使用模式。

方法

采用世界卫生组织医院抗菌药物使用监测方法,我们分析了东部地区医院6年的药房发药数据。我们报告了每100名患者的限定日剂量(DDD)、根据解剖治疗学分类(ATC)消耗的抗生素类型、世界卫生组织药物可及性、监测和储备(AWaRe)分类;抗生素消耗趋势以及每消耗一个DDD抗生素的支出。

结果

在此期间,平均(±标准差)抗生素消耗率为每年256.7±33 DDD/100名患者。线性回归模型显示抗生素消耗呈不显著的下降趋势(时间系数为-0.561;P=0.247)。在ATC 5级中,每100名患者消耗的前三种抗生素是阿莫西林-克拉维酸(DDD=372.6)、头孢呋辛(DDD=287.4)和磺胺甲恶唑-甲氧苄啶(DDD=145.8)。每年的可及-监测比从2016年的2.4降至2021年的1.2。抗生素的年均成本为394,206±57,618美元。按成本计算,消耗的前三种抗生素是克林霉素718,366.3美元、阿莫西林-克拉维酸650,928.3美元和头孢曲松283,648.5美元。

结论

本研究表明,在6年期间抗生素消耗率稳定,可及-监测抗生素比率逐年下降。药房药品发放数据为加纳医院和国家层面开展抗生素消耗监测提供了机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d68/10027653/db70edd39d37/dlad025f1.jpg

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