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Drug Utilization 75% (DU75%) in 17 European Hospitals (2000 - 2005): Results from the ESAC-2 Hospital Care Sub Project

[ Vol. 6 , Issue. 1 ]


Peter Zarb, Faranak Ansari, Arno Muller, Venessa Vankerckhoven, Peter G. Davey and Herman Goossens Pages 62-70 (9)


The study aimed to assess 75% of drug utilization (DU75%) in participating hospitals and identify quality indicators which should be used to monitor performance within the hospitals. In the European Surveillance of Antimicrobial Consumption (ESAC; project anatomic therapeutic chemical (ATC), defined daily dose (DDD) and route of administration (RoA) were used for drug categorization. Data were collected for: antibacterials for systemic use; intestinal antibiotics; rifampicin; and nitroimidazole derivatives. Each hospitals annual data were analyzed separately (hospital-year) adding up to a total of 97 hospital-year data-sets. The drug most persistently present within DU75% was ciprofloxacin (84/97 hospital-years). Co-amoxiclav was the drug which most frequently ranked first (28 times). The number of drugs constituting the DU75% by substance ranged from 7-15 (median 12) and 8- 19 (median 15) by RoA which identified oral amoxicillin most frequently ranking first (17 times). In many hospitals the oral route accounted for most of the DU75%. Therefore, the extent of oral use was identified as a quality indicator which could be monitored using DU75% methodology. Since substantial variation both in extent and distribution of antibiotic use was observed, DU75% methodology is best adapted for intra-hospital consumption trend analyses or for hospitals with comparable characteristics and formularies. The number of drugs within DU75% was identified as another quality indicator. Thus, aspiring to decrease the consumption of overused drug classes should be set by the hospitals as a quality indicator on prescribing patterns.


Hospital antimicrobial consumption, drug utilization, Cloxacillin, Doxyxycline, Amoxicillin and enzyme inhibitor, Benzylpenicillin, Clarithromycin, intestinal antibiotics, rifampicin, Flucloxacillin


Infection Control Unit, Mater Dei Hospital, Msida MSD 2090, Malta, Europe.

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