Variation of antibiotic consumption and its correlated factors in Turkey.

BACKGROUND: Presentation of antibiotic utilization data by reliable and comparable analyses constitutes an important way of ensuring rational use of antibiotics. This study aimed to evaluate antibiotic consumption (AC) of Turkey by each city/region and to investigate any association of such consumption with socio-economic factors. METHOD: For 81 provinces and 12 regions in Turkey, AC data from IMS (Intercontinental Medical Statistics) in 2011 was analyzed in accordance with "ATC/DDD, DID" (Anatomical Therapeutic Chemical/Defined Daily Doses, DID = DDD/1000 inhabitants/day) methodology supported by World Health Organization. Association between provincial AC rates and socio-economic development index (SEDI)-2011 and between regional AC rates and some health indicators were analyzed. RESULTS: While provincial AC data of Turkey was detected to vary between 17.2 and 55.2 DID (Hakkari and Usak, respectively), regional AC ranged from 28.4 to 48.9 DID (Middle Eastern Anatolia and Western Anatolia, respectively). Mostly consumed antibiotic group among all regions were beta-lactamase inhibitor/penicillin combinations (range: 9.9-17.6 DID). SEDI and AC of each city showed positive correlation (rho = 0.683, p < 0.001). While regional AC was positively associated with percentage of 14-year-old population (p = 0.002) and pharmacist density (p < 0.001), it was negatively associated with physician density (p = 0.038). CONCLUSION: It is remarkable that Turkey, at both provincial and regional levels, exhibits important variations in AC, which is proportional to socio-economic status. Besides, the consumption is found to be closely associated with recognized critical factors of access to healthcare. These findings are expected to provide important insights to the activities promoting rational use of antibiotics.

Factors affecting daily instrumental activities of the elderly.

BACKGROUND/AIM: In order to determine elderly people's capabilities in daily activities, we evaluated the factors that may affect their daily instrumental activities. MATERIALS AND METHODS: We performed an observational, analytical, and cross-sectional study on 101 patients above 60 years of age in 2008 and 2009. We applied the Lawton Instrumental Activity of Daily Living (IADL) scale, the Standardized Mini-Mental State Examination (SMMSE), and the Geriatric Depression Scale (GDS) during one-on-one interviews with the patients. Demographic data and disability levels were also recorded. These data were used to evaluate the possible effects of factors on the IADL scale. RESULTS: Statistical analyses indicated that total scores of instrumental activities are affected negatively by increased age, female sex, and literacy (P < 0.001, P = 0.005, and P = 0.021), whereas scores are affected positively by educational level (P = 0.047). CONCLUSION: Our findings suggest that increased age, sex, literacy, and education levels influence elderly people's daily instrumental activities. Daily functional activities and factors influencing these activities should be determined in order to increase elderly people's quality of life and independence. It is important to evaluate elderly people's capabilities in daily activities.