Análise do perfil de consumo de antimicrobianos em um hospital universitário do oeste do Paraná
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Arquivos
Data
2006
Autores
Caldeira, Luciane de Fátima [UNIFESP]
Orientadores
Burattini, Marcelo Nascimento [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
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Resumo
OBJETIVOS: Analisar a variação do consumo em Dose Diária Definida (DDD) e
determinar os gastos reais com o consumo de alguns antimicrobianos no Hospital
Universitário do Oeste do Paraná (HUOP) no período de 1999 a 2004. MÉTODOS:
Analisou-se o consumo de 9 antimicrobianos, sendo os resultados expressos em
DDD/100 pacientes-dia, consumidos no HUOP com exceção das unidades
pediátricas. Para avaliar os custos financeiros com estes fármacos em todo o
hospital, utilizou-se o preço médio de compra fornecido pelo relatório de consumo
da farmácia hospitalar. As variações anuais do consumo de cada antimicrobiano
estudado e dos gastos financeiros com os mesmos foram estudadas por análise
de variância (ANOVA) e por regressão linear. Adotou-se 5% como limiar de
significância. RESULTADOS: Os antimicrobianos mais consumidos no HUOP no
período deste estudo foram amicacina e ceftriaxona. Analisando-se o consumo
geral de todos os antimicrobianos selecionados observou-se um aumento
progressivo em DDD/100 pacientes-dia, ano após ano: 9,21 em 1999; 10,37 em
2000; 19,25 em 2001; 20,53 em 2002; 20,84 em 2003 e 25,08 em 2004
(p≤0,0001). Na análise por antimicrobianos verificou-se um aumento gradativo no
consumo para vários deles, como a ceftriaxona, a ceftazidima, o ciprofloxacino, a
clindamicina e o imipenem (p≤0,05). Entre as unidades analisadas, a UTI
apresentou o maior consumo médio anual em DDD/100 pacientes-dia, seguindose
as unidades de Quimioterapia e Clínica Médica. Em relação às médias mensais
do número de pacientes-dia atendidos, observou-se também aumento significativo
no período do estudo, passando de 2671 em 1999 para 3502 em 2004 (p≤0,0001).
Na análise do impacto financeiro observou-se um aumento significativo dos gastos
totais com os antimicrobianos quando comparado o período inicial com o período
final do estudo (médias anuais de R$ 98,89 por 100 pacientes-dia em 1999 x R$
731,26 por 100 pacientes-dia em 2004, p≤ 0,0001). CONCLUSÕES: Em relação ao
consumo dos antimicrobianos estudados observou-se aumento significativo em
DDD/100 pacientes-dia durante o período de 1999 a 2004. Também observou-se
um aumento de aproximadamente 30% no número de pacientes-dia atendidos no
período. O aumento no gasto geral com antimicrobianos, no entanto, superou em
muito o que seria esperado pelo aumento do consumo de antibióticos e do volume
de atendimento hospitalar observados.
OBJECTIVES: To analyze the annual variation of some antimicrobials’ consumption, in Daily Defined Doses (DDD) per 100 patients-day, and to determine the costs directly related to their use at the Hospital Universitário do Oeste do Paraná (HUOP) between 1999 and 2004. METHODS: The annual consumption of nine antimicrobials in DDD/100 patients-day was analyzed at HUOP, excluding the pediatric units. To evaluate the financial costs with the acquisition of those drugs, the annually averaged price of each antimicrobial analyzed reported by the Pharmacy Service of the hospital was used. Analysis of variance and linear regression techniques were used to evaluate the annual variation of each antimicrobial’s consumption and their financial costs. A significance level of 5% was considered. RESULTS: The most consumed antimicrobials in HUOP were amikacin and ceftriaxone. An increasing consumption of antimicrobials, in DDD/100 patients-day, was observed: 9.21 in 1999; 10.37 in 2000; 19.25 in 2001; 20.53 in 2002; 20.84 in 2003 and 25.08 in 2004 (p≤0.0001). Several antimicrobials had an almost linear increase on consumption, like ceftriaxone, ceftazidime, ciprofloxacin, clindamycin and imipenen (p≤0.05). With respect to specific hospital units, the ICU showed the highest antimicrobials consumption in DDD/100 patients-day, followed by Chemotherapy Unit and Medical Unit. In addition, the annual average number of patients-day increased in the study period from 2671 in 1999 to 3502 in 2004, p≤0.0001. The financial expenditure with the acquisition of antimicrobials at HUOP was high and steadily increased from the first to the last year of this study (annual averages of R$ 98.89/100 patients-day in 1999 x R$ 731.26/100 patients-day in 2004, p≤ 0,0001). CONCLUSIONS: Regarding all antimicrobials studied, between 1999 and 2004 a significant increase in consumption expressed by DDD/100 patients-day was observed. Also, an increase of about 30% in the annual average number of patients-day attended was observed in the period. However, the increase in the total expenditure with antimicrobials overcame by much (more than twice) what would be expected by the observed increase in the consumption of these drugs and in the number of hospital admissions.
OBJECTIVES: To analyze the annual variation of some antimicrobials’ consumption, in Daily Defined Doses (DDD) per 100 patients-day, and to determine the costs directly related to their use at the Hospital Universitário do Oeste do Paraná (HUOP) between 1999 and 2004. METHODS: The annual consumption of nine antimicrobials in DDD/100 patients-day was analyzed at HUOP, excluding the pediatric units. To evaluate the financial costs with the acquisition of those drugs, the annually averaged price of each antimicrobial analyzed reported by the Pharmacy Service of the hospital was used. Analysis of variance and linear regression techniques were used to evaluate the annual variation of each antimicrobial’s consumption and their financial costs. A significance level of 5% was considered. RESULTS: The most consumed antimicrobials in HUOP were amikacin and ceftriaxone. An increasing consumption of antimicrobials, in DDD/100 patients-day, was observed: 9.21 in 1999; 10.37 in 2000; 19.25 in 2001; 20.53 in 2002; 20.84 in 2003 and 25.08 in 2004 (p≤0.0001). Several antimicrobials had an almost linear increase on consumption, like ceftriaxone, ceftazidime, ciprofloxacin, clindamycin and imipenen (p≤0.05). With respect to specific hospital units, the ICU showed the highest antimicrobials consumption in DDD/100 patients-day, followed by Chemotherapy Unit and Medical Unit. In addition, the annual average number of patients-day increased in the study period from 2671 in 1999 to 3502 in 2004, p≤0.0001. The financial expenditure with the acquisition of antimicrobials at HUOP was high and steadily increased from the first to the last year of this study (annual averages of R$ 98.89/100 patients-day in 1999 x R$ 731.26/100 patients-day in 2004, p≤ 0,0001). CONCLUSIONS: Regarding all antimicrobials studied, between 1999 and 2004 a significant increase in consumption expressed by DDD/100 patients-day was observed. Also, an increase of about 30% in the annual average number of patients-day attended was observed in the period. However, the increase in the total expenditure with antimicrobials overcame by much (more than twice) what would be expected by the observed increase in the consumption of these drugs and in the number of hospital admissions.
Descrição
Citação
CALDEIRA, Luciane de Fatima. Análise do perfil de consumo de antimicrobianos em um hospital universitário do oeste do Parana 2006. 90 p. Dissertação (Mestrado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2006.