Análisis del uso ambulatorio de antibióticos en los hospitales generales de Asturias entre 2006 y 2015 / Analysis on the ambulatory usage of antibiotics at general hospitals in Asturias (2006-2015)

Introducción. La Organización para la Cooperación y el Desarrollo Económicos (OCDE) señala, en su informe sobre políticas de salud de 2017 que, España es uno de los países con mayor consumo en antibióticos, 21,6 DHD (dosis diaria definida por 1000 habitantes y día) en 2014 superior a los 20,5 DHD de media en sus países, situándose según el European Centre for Disease Prevention and Control (ECDC) en el puesto 11 de 30 países europeos en 2016. La prescripción ambulatoria de atención especializada se analiza con menor frecuencia, debido a la mayor contribución en consumo y gasto de la atención primaria. Material y métodos. Estudio descriptivo, observacional, y retrospectivo del consumo y gasto del grupo J01 derivado de la prescripción ambulatoria (consulta externa y urgencias) de los hospitales públicos generales de Asturias, en una década (2006- 2015). Se estudió el consumo a través de la base de datos de facturación de receta del Servicio de Salud del Principado de Asturias, los datos demográficos se obtuvieron del Instituto Nacional de Estadística. El consumo se expresó en DHD y el gasto: en gasto por habitante e importe por dosis diaria definida. Resultados. El consumo medio ambulatorio global del periodo fue de 23,4 DHD, correspondiendo el 11,5% (2,7 DHD) a la receta ambulatoria de atención especializada. En términos de gasto, supuso el 13,6% del gasto global ambulatorio en antibióticos. Conclusiones. Gasto y consumo tuvieron tendencias opuestas, las medidas de control del gasto no tuvieron, o tuvieron poco impacto en consumo, por tanto, se precisan en este ámbito medidas de racionalización independientes y específicas (AU)

Introduction. The Organization for Economic Co-operation and Development (OECD) emphasize, in its report on health policies from 2017 that, Spain is one of the countries with largest consumption of antibiotics, 21.6 DHD (defined daily dose per 1000 inhibitants per day) in 2014 greater than the average 20.5 DHD in their countries, ranking according to the European Center for Disease Prevention and Control (ECDC) in the 11th place out of 30 European countries in 2016. The outpatient prescription of specialized care is analyzed less frequently, due to the greater contribution in consumption and expenditure of primary care. Material and methods. A descriptive, observational, and retrospective study of the consumption and expenditure of the J01 group derived from outpatient prescription (outpatient and urgent care) of public hospitals in Asturias, in a period of ten years (2006-2015). Consumption data were obtained using the database of prescription billing of the Health Service of the Principality of Asturias, demographic data were provided by the National Institute of Statistics. Consumption was expressed in DHD and antibiotics expenditure in: expenditure per capita and expenditure in euros per defined daily dose. Results. The average global ambulatory consumption for the period was 23.4 DHD, corresponding 11.5% (2.7 DHD) to the ambulatory specialty care prescription. In terms of expenditure, it accounted for 13.6% of overall outpatient spending on antibiotics. Conclusions. Outlay and consumption had opposite tendencies, the expenditure control measures did not have or had little impact on consumption, therefore, independent and specific rationalization measures are required in this area (AU)

[Consumption of antibiotics of the general population of Segovia area during the period between 1999 to 2007]. / Consumo de antibióticos en la población general del área de Segovia durante el período 1999 a 2007.

INTRODUCTION: The antibiotics are the medicaments most used after the analgesics, being prescribed more than 85 % in Primary Care. The aim of the study is to analyze the evolution of the prescription of antibiotics of systemic use in the general population of the Area of Segovia, during the years 1999-2007 and to know his trends evolution. MATERIAL AND METHODS: Antibiotics prescribed to the general population on the part of the Family physicians were processed using the information system of drugstore "CONCYLIA" that supplies the information in the shape of defined daily dose (DDD), transformed later into the indicator DHD (DDD for 1.000 inhabitants per day) taking as a base the population information of sanitary card. RESULTS: The global prescription of antibiotics of systemic use was high, 18,06 DHD (IC:17,22-18,90), with a variable evolution along the study in the shape of basin of low concavity. The percentage of prescription of penicillins was 64.42 % of the total of prescriptions corresponding to the group J01. CONCLUSIONS: The prescription in the Area of Segovia has presented a contained consumption in relation to other studies, showing differences in the volume of prescription from each the subgroups. The centralization of the consumption emphasizes in the subgroup of penicillins that supposed almost two third parts of the prescribed DDD. A change in the habits of prescription is observed detailing a decrease of the amoxicillin use and an increase of amoxicillin-clavulanic acid.