Indicators of antibiotic use in primary health care of Republic of Srpska

Abstract

The WHO developed the many indicators to evaluated the rational use of drug, as following: availability of drug, cost of drug therapy, drug cost of antibiotics in ratio of all drug cost etc. OBJECTIVES: The purpose of research was to analysed the antibiotic use in primary health care of part of Republic of Srpska (RS) with commonly and complementary indicators. METHODS: A retrospective analysis of prescribing of antibiotic in setting of data centre of Rp evaluation of Community Pharmacy chain of Banja Luka (BL)(RS), was conducting using the 1990, 1994, 1998 and 2000 survey. The analysis covered the four main group of antibiotics by indicators: defined daily dosage (DDD)/1000 inhabitants/days; % of antibiotics and cost vs. all drugs. The comparison was done with survey of “reference case” in Serbia and Montenegro (SM) and Clinical-hospital centre of BL (ChcBL). Fischer test and SD statistical method was used and multivariate analyses, as well. RESULTS: The study included the 17 retail pharmacy settled in area of BL with the total pop- ulation of ~350,000 people. The average use of antibiotic is 42% (32%, 60%, 37%, 40%, respectively to time frames) and higher than the use in SM (33%) and similar to use in ChcBL. The structural analysis were show that the penicillin’s and cephalosporin’s was the two main pre- scribing antibiotic group. In deep multivariate analyses we were recognised the radically changes in prescribes practices after the year 2000 (increasing use of amoxi- cillin and combination, instead of ampicillin). The in ser- vices training of health workers (PHARE program) and the inclusion of combination in the local reimburse- ment list have had important role on the former results. CONCLUSIONS: Complementary indicators of use of antibiotics in the primary health care systems of BL showed that the rational antibiotic use approach was present, after strong drug policy were developed and implemented.