Xiaoyuan Qu is a PhD candidate of Social Medicine and Health Management at Shandong University. His research field is antibiotic use and management
Introduction: Antibiotic drug consumption is a major driver of antibiotic resistance. China has built Center for Antibacterial Surveillance (CAS) to monitor antibiotic use of hospitals in 2005. CAS currently has 192 core member institutions; all of them are tertiary hospitals. Methods: Valid data of inpatient antibiotic consumption of 183 tertiary hospitals during the period 2011-2014 have been collected using ATC/DDD and expressed in Defined Daily Dose (DDDs). We used compound annual growth rates (CAGR) to analyze the consumption sum and DDDs. Results: The CAGR of DDDs and costs of antibiotic use in 183 tertiary hospitals is -6.02% and -5.58%. The most consumed drugs were cephalosporins (an average DDDs of 46.35% a year), which also costs accounted for the most (an average of 48.38% a year). The proportion of DDDs of carbapenems has been growing from 2011 (6.99%) to 2014 (6.92%), CAGR was 4.81%, which the most used drugs were meropenem and with the DDDs growing, the proportion of costs of carbapenems increased rapidly, CAGR was 9.67%. In method of antibiotic administrator, the injection method was the most used, which average proportion of DDDs for four years was 84.55%, and the average proportion of consumption amount was 94.95%. Conclusion: Implementing of a series of antibacterial stewardship policies, had an effect to control DDDs of antibiotic consumption, but costs control was weak. Increasing use of carbapenems shows that there is a risk of bacteria resistance in tertiary hospitals in China.
Fadya Hamadani has acquired her BSc in Pharmacy and MSc in Clinical Pharmacy from College of Pharmacy, Baghdad University (1992, 1998 respectively). She is Assistant Professor in Clinical Pharmacy and since that period, she has built a variety of experience in research, evaluation, teaching in higher education institutions and providing hospital training. Currently she is a full time PhD student at the School of Pharmacy and Pharmaceutical Sciences, Cardiff University. Her PhD project involves identification of issues around safe and effective administration and management of medicines in care homes. Her research interest includes the rational use of antibiotics in care homes.
Statement of the Problem: Residents of care homes are noted for the complexity of their care needs, multiple co-morbidities and the incidence of polypharmacy. This makes them particularly susceptible to medicines related harm. Antibiotic prescribing in care homes is particularly prevalent and their inappropriate administration risks the development of antimicrobial resistance. The aim of this present study was to identify the prevalence and types of prescribing and administration errors related to antibiotics in Care Homes Methodology & Theoretical Orientation: A retrospective study was conducted in 12 Care Homes in South Wales over an eight month period (Feb-Oct 2015). Anonymised real-time data was collected from an electronic medicines management system and the prevalence of antibiotic determined. The data was also analyzed for errors related to the prescribing and administration of antibiotics. The type and frequency of medication errors were recorded in excel and selected data was transferred into SPSS for further analysis. Findings: A total of 142 (43.16%) residents received at least one antibiotic over the study period. The most commonly prescribed antibiotic was trimethoprim (24.6%). Some 9499 administrations were analyzed against pre-defined medication error categories with 2247 medication errors identified, 79.6% of residents were exposed to at least one error. The most frequent administration error type was duration error (44.5%) where the antibiotic was administered either for a period shorter or longer than the prescribed duration, followed by dose omissions errors (38.9%). The most common prescribing error type was similarly duration errors (74.3%) Conclusion & Significance: This evaluation of the management of antibiotics in care homes in South Wales has revealed that the prevalence of antibiotic prescribing along with the incidence of administration and prescribing errors related to antibiotics is significant. This may result in antimicrobial resistance in a particularly vulnerable patient cohort