Author/Editor		Čižman, Milan; Pečar-Čad, Silva
Title		Uporaba protimikrobnih zdravil v Sloveniji in Evropi. Kje smo in kaj naj storimo?
Translated title		Use of antimicrobial drugs in Slovenia and Europe. Where are we and what we should do?
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 43, št. Suppl 2
Publication year		2004
Volume		str. 3-10
Language		slo
Abstract		Antibiotic resistance is a major health problem and the level of antibiotic use is recognized as the leading factor driving the resistance. Slovenia is one of the 31 European countries participating in European Surveillance on Antibiotic Consumption (1997-2002) project. We assessed the levels of out- and inpatient use of systemic treatment of bacterial infections, by calculating the number of Defined Daily Doses per 1000 inhabitants per day (DID) according to the WHO ATC/DDD methodology. In Slovenia in 2002 the total outpatient antibiotic use was 16.32 DID and 1.8 DID in inpatients. The consumption in Slovenia is moderate comparing to other European countries. In ambulatory care penicillins (58%), macrolides (19%), fluoroquinolones (7%), and in hospital care penicillins (54%), cephalosporins (11%), fluoroquinolones (9%) and macrolides (4%) were the most commonly prescribed classes of antibiotics. Combinations of penicillins with beta-lactamase inhibitors represent 20% of all prescribed antibacterials in ambulatory care and 31% hospital care. In Slovenia we should decrease the total antibiotic consumption in out- and inpatients for 10-20% to reduce the resistance of common bacterial pathogens. The consumption of penicillins with extended spectrum, 3rd generation cephalosporins, fluoroquinolones, and macrolides should be reduced as well. Continuous monitoring of antibiotic consumption and prevalence of resistance should be done to develop the strategy for prudent use of antibiotics in ambulatory and hospital care.
Summary		Odpornost bakterij je velik zdravstveni problem in antibiotiki s selekcijskim pritiskom so najpomembnejši dejavnik v nastanku in vzdrževanju odpornosti. Slovenija je ena od 31 držav, ki sodeluje pri evropskem projektu (1997-2002) o porabi protibakterijskih učinkovin za sistemsko zdravljenje okužb. Porabo antibiotikov smo izražali v definiranih dnevnih dozah (DDD) po ATC/DDD metodologiji, ki jo priporoča Svetovna zdravstvena organizacija. V Sloveniji je bila celokupna ambulantna poraba antibiotikov v letu 2002 16,32 DDD/1000 prebivalcev na dan in v bolnišnicah 1,8 DDD/1000 prebivalcev na dan, kar nas uvršča v srednjo tretjino držav porabnic antibiotikov v Evropi. V letu 2002 smo v ambulantah predpisali največ penicilinov (58%), sledijo makrolidi (19%) in kinoloni (7%) in v bolnišnicah največ penicilinov (54%), sledijo cefalosporini (11%), kinoloni (9%) in makrolidi (4%). Penicilini v kombinaciji z zaviralci laktamaz beta predstavljajo v ambulantah 20% in v bolnišnicah 31% vseh predpisanih antibiotikov. V Sloveniji moramo zmanjšati celokupno porabo antibiotikov v ambulantah in bolnišnicah za 10-20%, predvsem moramo omejiti porabo širokospektralnih penicilinov, cefalosporinov 3. generacije ter kinolonov in makrolidov. V bodoče moramo stalno spremljati porabo antibiotikov in odpornost bakterij, kar sta osnovi za načrtovanje smiselne porabe antibiotikov v ambulantah in bolnišnicah.
Descriptors		ANTIBIOTICS DRUG RESISTANCE, MICROBIAL DRUG UTILIZATION REVIEW SLOVENIA AMBULATORY CARE