Phamacoeconomic analysis of antibiotics use in the Clinical Center of Vojvodina

INTRODUCTION: The investigation was performed in three phases and included all patients hospitalized at eight selected clinics known to be the biggest antibiotic spenders in the Clinical center of Vojvodina. MATERIAL AND METHODS: The first phase comprised retrospective evaluation of the total antibiotic use in therapy of all bacterial infections during a three-month period in 2006/2007. A total cost of all spent antibiotics was calculated, and a daily dose per 100 clinical day care was defined for each of investigated clinics. In the second phase, the structure of bacterial causes and their resistance to standard antimicrobial therapy was established for all isolated strains from each clinic. According to the the results of bacterial resistance surveilance, guidelines for initial adequate antimicrobial therapy were made (regarding localization and type of bacteria) considering resistance maps for isolated bacterial strains. The guidelines took into consideration all essential ellements: pharamcotherapeutic/pharmacoeconomic principles, bacterial resistance, patterns of antimicrobial prescriptions and lowest therapy costs. RESULTS AND CONCLUSION: In the third phase, (three-month period in 2007/2008), the guidelines were implemented in therapy of bacterial infections. In this period, only by implementing the guidelines for initial adequate antimicrobial therapy, the therapy costs savings were 2027018.52 dinars (12.8%) at four of eight investigated clinics, compared to the period before implementation of the guidelines. This was the first pharmacoeconomic study in Vojvodina.