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Comparison of alterations in frequency and cost of antibiotic use in neonatal and pediatric ıntensive care units of a hospital following protocol to an education and research hospital

Mustafa Doğan, İbrahim Yılmaz, Gamze Varol Saraçoğlu.

AİM: The objective of this study is to show the alterations in frequency and cost of antibiotic use in neonatal and pediatric intensive care units of a state hospital after it started to service as an education and research hospital. We also aimed to raise an awareness related to rational antibiotic use.
METHODS: The surveillance of antibiotic use and comparison of costs were evaluated in 392 patients in between August 2013-January 2014. The rate and cost of antibiotic use during last 90 days before the protocol of state hospital to research and education hospital and the first 90 days after protocol were evaluated. Antibiotics were assessed according to the treatment protocols of the Committee of Rational Drug Use, Infection Control Committee and Antibiotic Control Committee. Antibiotics were provided from administrative system and the data related to costs were obtained from Ministry of Health and Ministry of Finance. The demographic data and the data related to indication for admission to intensive care units, antibiotic dosages and pathogens causing infections were also obtained. For statistical analysis, SPSS program was used and descriptive analysis were made. In comparison of the groups, Mann Whitney U and chi-square tests were used. The data were evaluated within a 95% confidence interval.
RESULTS: In first and second period, 143 patients were hospitalized for 3.18±1.13 days and 105 patients were hospitalized for 2.69±4.14 days in pediatric intensive care unit(PICU); 79 patients were hospitalized for 17.29±3.61 days and 65 patients stayed for 21.29±3.29 days in neonatal intensive care unit(NICU), respectively. In the first and second period, cost of antibiotics in PICU was found 341.81±744.49 (med:14.91) and 585.35±796.62 (med:256.44) (p=0.02) Turkish Liras (TL); in NICU 137.92±178.78 (med:14.59) and 247.40±370.13(med:19.23) (p=0.76) TL respectively.
CONCLUSİON: In the second period, in PICU, duration of hospitalization was found to decrease and costs of antibiotics were higher. In NICU, the duration of hospitalization was longer and although statistically insignificant, costs of antibiotics were slightly higher. Differences between the two periods in term of cost showed that, PICUs and ICUs should revisit their antibiotic preferences from the viewpoint of a pediatric infectious disease physician.

Key words: Neonatal intensive care unit (NICU), rational antibiotic use, pediatric intensive care unit (PICU).

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