Author/Editor		Reberšek-Gorišek, Jelka; Drofenik, Polonca
Title		Poraba rezervnih antibiotikov v Splošni bolnišnici Maribor od januarja 1998 do novembra 2001
Translated title		The usage of antimicrobial drugs at the Maribor General hospital from 1998 to 2001
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 41, št. Suppl 2
Publication year		2002
Volume		str. 61-6
Language		slo
Abstract		The Committee for Rational Use of Antibiotics has been in existence at the Maribor General Hospital since 1985. Its main purposes are the education of, and consultations with, physicians concerning the prescribing of antibiotics, with the objectives of achieving more rational use and reducing treatment costs. The consumption of all antibiotics is monitored by computer and is measured at the hospital as defined daily doses of antibiotics per 100 bed days. These data are regularly analyzed by the committee and presented annually to the board of directors, together with a report on the situation regarding resistance of nosocomial bacteria, prepared in cooperation with the Microbiology Center of the Slovene Institute of Public Health. Consultations on the prescribing of antibiotics are based on these data. In 1998, the Committee introduced a form with a schedule of antibiotics that are reserved only for certain infections. The form was copied from one at the Ljubljana Medical Center, with a small supplement. The schedule of reserve antibiotics includes ceftazidime, cefoperazone, cefpirom, imipenem, meropenem, aztreonam, vancomycin, teicoplanin, amikacin, tobramycin, chloramphenicol, lipid amphotericin B, nonliposomal amphotericin B and piperacillin + tazobactam. A reserve antibiotic may be prescribed only after consultation with an infectious disease specialist. This measure does not, however, apply to intensive care units or hematology units. Since the introduction of this form, the consumption of reserve antibiotics has reserve antibiotics are vancomycin and ceftazidime, but even the usage of these has been decreasing gradually. The decrease in the usage of reserve antibiotics has been achieved through regular consultations with infectious disease specialists and good cooperation with in-hospital pharmacists. (Abstract truncated at 2000 characters).
Summary		Komisija za smotrno uporabo antibiotikov deluje v Splošni bolnišnici Maribor od leta 1985 dalje. Glavni namen delovanja komisije je poučevanje in svetovanje pri predpisovanju antibiotikov s ciljem, doseči njihovo racionalnejšo uporabo in zmanjševati stroške zdravljenja. Poraba vseh antibiotikov se spremlja računalniško in se meri v bolnišnici s številom dnevnih definiranih odmerkov antibiotika na 100 oskrbnih dni. Te podatke komisija redno analizira in jih letno predstavi kolegiju predstojnikov hkrati s poročilom o stanju odpornosti bakterij v bolnišnici, ki je pripravljeno v sodelovanju z mikrobiloškim centrom zavoda za zdravstveno varstvo. Na osnovi teh podatkov se svetuje pri predpisovanju antibiotikov. Leta 1998 je komisija uvedla obrazec z listo antibiotikov, ki so rezervirani samo za določene okužbe. Obrazec je posnet po kliničnem centru v Ljubljani z majhno dopolnitvijo. Na listi rezervnih antibiotikov so: ceftazidim, cefoperazon, cefpirom, imipenem, meropenem, aztreonam, vankomicin, teikoplanin, amikacin, tobramicin, kloramfenikol, lipidni amfotericin B, neliposomni amfotericin B in piperacilin-tazobaktam. Rezervni antibiotik se lahko predpiše le po posvetu z infektologom. Ta ukrep ne velja za intenzivne enote in hematološki oddelek. Z uvedbo obrazca je poraba rezervnih antibiotikov v upadanju. Najpogosteje uporabljena rezervna antibiotika sta vankomicin in ceftazidim, pa tudi njuna poraba postopno pada. Upadanje porabe rezervnih antibiotikov je doseženo z rednimi posveti z infektologi in z dobrim sodelovanjem s farmacevti v bolnišnici. Takšen način dela bi bilo smiselno prenesti na celotno področje predpisovanja antibiotikov v bolnišnici s pričakovanim rezultatom znižanja ležalne dobe bolnikov z bolnišnično okužbo, znižanja števila bolnišničnih okužb, znižanja umrljivosti in stroškov zdravljenja. Za takšen način dela je potrebno ustrezno število infektologov.
Descriptors		DRUG UTILIZATION HOSPITALS, GENERAL ANTIBIOTICS