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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Defined daily doses of antimicrobials reflect antimicrobial prescriptions in ambulatory care

Dominique L Monnet1, Sigvard Mölstad, Otto Cars

  • 1Antimicrobial Resistance Surveillance Unit, National Center for Antimicrobials and Infection Control, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark. dom@ssi.dk

The Journal of Antimicrobial Chemotherapy
|May 1, 2004
PubMed
Abstract

Insights

The World Health Organization's defined daily doses (DDDs) strongly correlate with actual antimicrobial prescriptions in European outpatients. This confirms DDDs are a relevant unit for comparing antimicrobial use across countries.

Area of Science:

  • Pharmacology
  • Public Health
  • Epidemiology

Background:

  • Actual antimicrobial prescription data is scarce, hindering accurate international comparisons.
  • The World Health Organization (WHO) recommends defined daily doses (DDDs) for comparing outpatient antimicrobial use.
  • Concerns exist that DDDs may not accurately reflect real-world prescription practices.

Purpose of the Study:

  • To assess the correlation between defined daily doses (DDDs) and actual antimicrobial prescriptions in European outpatients.
  • To validate the use of DDDs as a reliable metric for international comparisons of antimicrobial consumption.

Main Methods:

  • Data on outpatient antimicrobial sales and prescriptions from 13 European countries in 1997 were obtained from IMS Health and national agencies.
  • Statistical analysis, including two-tailed Spearman correlation, was used to compare DDDs with prescription numbers and use density with prescription rates.

Main Results:

  • A strong positive correlation was observed between the number of DDDs and the number of antimicrobial prescriptions in European outpatients.
  • Antimicrobial use density (DDD per 1000 inhabitant-days) was also strongly correlated with the prescription rate (prescriptions per 1000 inhabitants).
  • These correlations held true for overall systemic antimicrobials and major antimicrobial classes.

Conclusions:

  • The study confirms that defined daily doses (DDDs) per 1000 inhabitant-days is a relevant and reliable unit for comparing outpatient antimicrobial use across countries.
  • The findings support the continued use of DDDs for international surveillance and policy-making regarding antimicrobial consumption.

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