Application of the Atc/ddd Methodology to Compare Antibiotic Utilization in Two University Hospital Surgical Departments

To analyze overall drug consumption, compare antibiotic utilization in particular, and evaluate whether sound principles of surgical prophylaxis are applied at urology clinics of two university hospitals. The study was carried out at the urology clinics of the Department of Surgery, University Clinical Center in Niš, and the Institute of Surgery, University Teaching Hospital in Novi Sad, Serbia. Anti-microbial consumption was calculated during a two month period as the number of Defined Daily Doses (DDDs) per 100 bed days (BD) for all antiinfectives for systemic use, i.e. group J of the Anatomical Therapeutic Chemical (ATC) classification and for classes of this group. Antibiotics are the most frequently prescribed drug group at the Urology Clinic in Niš, amounting to 263.54 DDD/100 BD (43.05 % of total drug consumption). Co-trimoxazole (204.35 DDD/100 BD), quinolones (29.81 DDD/100 BD) and aminoglycosides (18.88 DDD/100 BD) were prescribed most. In Novi Sad, antibiotic utilization amounted to 224.85 DDD/100 BD. Similarly, co-trimoxazole was most frequently prescribed (129.03 DDD/100 BD), followed by cephalosporins (43,54 DDD/100 BD) and aminoglycosides (20.5 DDD/100 BD). In most instances, the chosen antibiotics for surgical prophylaxis were in accordance with the international guidelines. However, overuse was noted extending to the postoperative period. We believe that indications for the anti-microbial use still need a critical evaluation and that irrational use should be discouraged.