[Simple parameters of antibiotic utilization and diagnostic background of antimicrobial therapy in Hungarian...

This paper is published as second part of a survey on antibiotic utilisation of 8 Hungarian hospitals in January, 1995. The length of hospital stay of the patients receiving systemic antibiotic treatment was significantly higher (P < 0.0001) than those of not receiving such treatment. After exclusion of the patients suffering from nosocomial infections, average of the excess of hospital days was 4.65. Comparing the figures of patients receiving one or more antibiotic/one hospital stay and the rate of monotherapy and combined therapy and number of used antibiotics/100 discharged patients or/100 patients treated with antibiotics it was found that these indexes were most favourable in that hospital, where antibiotic policy was in function. Examining diagnoses (perioperative profilaxis 32.7%, pneumonia 13.3% of the 753 diagnoses) and drugs (metronidazol 26.3%, aminoglycosides 20% of the 1455 antibiotics) most frequently found in cases of combined antibiotic therapy it was concluded that parallel treatment with two or more antibiotic was often unjustified. Only 11% of antibiotics was used as directed against known bacteria. It was found that the rate of the achieved microbiological examinations and targeted therapy was low even if microbiological samples were easy to obtain. It was not the main purpose of the survey to get data of the clinical diagnostic background of antibiotic therapy, but indirect signs showed that these drugs were often used without sufficient clinical evidences (anamnesis, physical status, labor, X-ray and other tests) of infection. Authors recommend further survey in order to find out the causes of insufficiency of diagnoses. They also propose elaboration of diagnostic protocols.