Nationwide use of antibiotics in slovenian hospitals in the period 2004-2008 – From national to department level

Background: antibiotics are among the most commonly prescribed drugs in hospitals. Hospitals are the epicenters of the development of bacterial resistance. Th e aim of the article is to present the data on antibiotic consumption at national level as well as at the level of diff erent hospital types in the period 2004 to 2008 and departments in the period 2006 to 2008. Methods: the data for hospital care were collected using the Anatomic Th erapeutic Classifi cation (ATC/defi ned daily doses (DDD) (WHO version 2008). Th e results were expressed in DDD per 100/bed-days, or DDD/100 admissions and DDD per 1000 inhabitants per-day (DID). Results: in the period 2004 to 2008 the overall consumption of antibacterials for systemic use was between 48.6 and 50.4 DDD/100 bed-days, between 317.5 and 328.9 DDD/100 admissions and 1.69 and 1.70 DID respectively. Th e consumption varied substantially among diff erent types of hospitals, as well as among hospitals and departments of the same type. Th e highest consumption was in hospitals for respiratory diseases, university and general hospitals. In 2008 the most frequently prescribed classes of antibiotics were penicillins (39.8%), cephalosporins and other beta-lactams (22.8%), fl uoroquinolones (14.6%), macrolides with lincozamides (92%) and other antibacterials (5.3%). Among departments in Slovenia, the highest consumption was at surgical and medical ICUs followed by mixed ICUs, medical, surgical, pediatric and gynecological departments. Conclusion: Th e hospital consumption in Slovenia is moderate and stable. Th e data provide a basis for interventions to improve antibiotic prescribing and evaluation of the correlation between antibiotic consumption and resistance.