Turkish Journal of Medical Sciences




To determine antimicrobial use in a university hospital in Turkey and compare it with United States antimicrobial use and resistance (US-AUR) and International Nosocomial Infection Control Consortium (INICC) rates. Materials and methods: This was a prospective surveillance study done between January 2007 and December 2007. The data are standardized by use of the defined daily dose (DDD) for each antimicrobial group and by calculating use per 1000 patients (antibiotic use density-AD). Results: Data on 35,936 patients with a total of 215,616 patient-days were analyzed. Ampicillin group (mainly with a beta lactamase inhibitor) has the highest AD in ICU and non-ICU departments (AD was 308 and 244 DDD/1000 patient day, respectively). Compared with the US-AUR rates ADs for ampicillin group, antipseudomonal penicillin group, 1st generation cephalosporins and carbapenems were over the 75th percentile for almost all types of ICU. Fluoroquinolones AD was below the 10th percentile at most ICUs. Inversely compared with INICC data, none of antimicrobial group exceeded the 90th percentile for all ICUs. There was a statistically significant (P < 0.01) correlation between incidence densities of all nosocomial infections and ventilator utilization rate with the use of antipseudomonal penicillins, 3rd generation cephalosporins, carbapenems, and glycopeptides at ICUs. Conclusion: We found a positive correlation with nosocomial infections densities and the use of broad spectrum antimicrobials in ICUs. To use antimicrobials wisely we must implement a comprehensive education program together with infection control measures. A national program for antimicrobial usage may provide more precise data for inter-hospital comparisons.


Antibiotic surveillance, daily defined dose

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