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Hungarian Hospital Antibiotic Consumption at the Regional Level, 1996–2005

Infection volume 37, pages 133–137 (2009)Cite this article

Abstract

Background:

Regional variations in antibiotic consumption in outpatients have been reported previously, but nothing is as yet known about the regional distribution of antibiotic consumption in the hospital sector in Hungary. This study was designed to explore regional variations and investigate determinants of antibiotic consumption in hospital care in Hungary.

Materials and Methods:

Regional distribution-based antibiotic sales data were obtained for a 10-year period (1996–2005) for the 20 Hungarian counties. Systemic antibacterial use (Anatomical Therapeutic Chemical code: J01) was expressed as the number of defined daily doses (DDD) per 100 patient-days. The multiple linear regression model was applied to investigate the determinants of regional differences in hospital antibiotic consumption. Independent variables related to health care access, utilization of hospital resources, doctors’ workload, type of hospital care provided, and patient’s characteristics and infections were considered as possible determinants, and data on these variables were obtained for 2 years (2004, 2005). We also tested the association between hospital and ambulatory care antibiotic consumption in Hungarian regions using the Pearson correlation test.

Results:

For each year during the 1996–2005 study period, there were large and stable variations in total hospital antibiotic consumption (e.g., min–max1996: 16.0–28.2; min–max2005: 15.2–32.2 DDD per 100 patient-days) depending on the region. In the two developed models (Model 1 and Model 2), the number of reported infections accounted for 53% of the observed regional variations in hospital antibiotic consumption (Model 1), and the number of reported infections together with the case-mix index were responsible for 61% (Model 2) . Total antibiotic consumption in hospitals showed a positive correlation (R = 0.71, p = 0.002) with total antibiotic consumption in ambulatory care.

Conclusion:

The case-mix index and the number of reported infections explained some of the observed regional variations. However, the moderate value of the models in explaining these regional variations suggest that determinants which could not be explored in this preliminary study may also contribute to regional differences. Future studies should aim at collecting data for each individual hospital as well as data on possible determinants for hospital antibiotic consumption.

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Affiliations

  1. Dept. of Clinical Pharmacy, University of Szeged, Szikra u. 8, 6725, Szeged, Hungary

    R. Benko, M. Matuz, P. Doro, R. Viola & G. Soos

  2. Dept. of Clinical Microbiology, University of Szeged, Szeged, Hungary

    E. Hajdu

  3. National Center for Antimicrobials and Infection Control, Statens Serum Institute, Copenhagen, Denmark

    D. L. Monnet

  4. Scientific Advice Unit, European Centre for Disease Prevention and Control, Stockholm, Sweden

    D. L. Monnet

Authors
  1. R. Benko
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  2. M. Matuz
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  3. P. Doro
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  4. R. Viola
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  5. E. Hajdu
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  6. D. L. Monnet
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  7. G. Soos
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Correspondence to R. Benko.

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Benko, R., Matuz, M., Doro, P. et al. Hungarian Hospital Antibiotic Consumption at the Regional Level, 1996–2005. Infection 37, 133–137 (2009). https://doi.org/10.1007/s15010-008-7468-6

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  • DOI: https://doi.org/10.1007/s15010-008-7468-6

Keywords

  • Ambulatory Care
  • Antibiotic Consumption
  • Anatomical Therapeutic Chemical Code
  • Hospital Consumption
  • National Health Fund