ANTIMICROBIAL CONSUMPTION AT THE HOSPITAL LEVEL IN LATIN AMERICA. SIMILARITIES AND DIFFERENCES ACCORDING TO EACH COUNTRY.
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Keywords
antimicrobials, consumption, Latin America, Hospital, AWaRe, WHO
Abstract
One of the main problems for health service around the world is the antimicrobial resistance (AMR).
Objective: to describe the antimicrobial consumption (AMC) at hospital level in Latin American countries and compare the amount and type of antibiotics usage among them in order to guide local public health actions towards AMR prevention.
Design: A descriptive study of antimicrobial consumption at hospital level among six health institution in Latin America with an analytical comparative stage. Antimicrobials included corresponded to the WHO Anatomical Therapeutic Chemical (ATC) classification system subgroups: J01, A07A and P01AB.
Methods: WHO GLASS methodology was applied for surveillance of AMC, using the ATC classification based on Defined Daily Dose (DDD) and DDD/100 hospital discharges as standard unit of measurement. Antimicrobials consumed were also classified according to the WHO Access-Watch-Reserve (AWaRe) classification.
Results: The quantitative data, measured in DDD/100 hospital discharges, showed a wide range of consumption (182.48 - 2260.95). Qualitative analysis according to the AWaRe classification also showed a wide range in terms of consumption of Access (38.14% - 73.64%), Watch (24.93% - 60 .53%) and Reserve (0.31% - 3.55%) groups expressed as a percentage of the total consumption.
Conclusion: Great heterogeneity and arbitrariness exist in the selection of antimicrobials for hospital use. Although this situation might be explained on local antimicrobial resistance, the history of prescription, local pharmaceutical promotion, and pharmacological education of health professional in each country, particular habits and distinctive culture may justify the differential consumption patterns observed in each institution in this study.
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Gustavo Marin
University Center for Pharmacology (CUFAR). Faculty of Medical Sciences. National University of La Plata (UNLP). Argentina.
Lucia Giangreco
University Center for Pharmacology (CUFAR). Faculty of Medical Sciences. National University of La Plata (UNLP). Argentina.
Yago Hernández
University Center for Pharmacology (CUFAR). Faculty of Medical Sciences. National University of La Plata (UNLP). Argentina.
Cristian Dorati
University Center for Pharmacology (CUFAR). Faculty of Medical Sciences. National University of La Plata (UNLP). Argentina.
Perla Mordujovich-Buschiazzo
University Center for Pharmacology (CUFAR). Faculty of Medical Sciences. National University of La Plata (UNLP). Argentina.
María Rosa Bay
PharmacyService, HIGA San Roque, Gonnet, La Plata. Argentina.
Gladys María Adriana Gonzalez
PharmacyService, HIGA San Roque, Gonnet, La Plata. Argentina.
Francisca Aldunate
Pontifical Catholic University (PUC). Chile
Mónica López Peña
Directorate of Medicines and Technologies in Health. Ministry of Health and Social Protection. Colombia.
Shing Mi Ching Fung
CostaRican social security (CCSS). Costa Rica.
Adriana Martínez Parra
Directorate of Medicines and Technologies in Health. Ministry of Health and Social Protection. Colombia.
María José Alfonso Arvez
National Health Surveillance Directorate (DINAVISA). Ministry of Public Health and Social Welfare. Paraguay.
Hilda Mantilla Ponte
General Directorate of Medicines, Supplies and Drugs (DIGEMID). Ministry of Health. Perú.
Danini Marin
Pan-American Health Organization (PAHO). Washington DC, USA
ROJAS-CORTES ROBIN
Pan-American Health Organization (PAHO). Washington DC, USA
CASTRO JOSE LUIS
Pan-American Health Organization (PAHO). Washington DC, USA