Evaluating the Pattern of Use and Direct Cost of Injectable Antibiotics Before and After Health Transformation Plan at Namazi Hospital in Shiraz

Abstract

Background: The inappropriate use of antimicrobials in outpatient and inpatient settings has led to the spread of microbial resistance, reduced clinical effectiveness of antimicrobial drugs, and significant direct and indirect costs. Various programs have been implemented to improve antimicrobial usage patterns. The study examined how the Health Transformation Plan (HTP) affected prescribing injectable antibiotics and costs at a referral teaching hospital. Methods:  A retrospective observational study was conducted covering the periods 2011 to 2014 (pre-HTP period) and 2014 -2017 (post-HTP period) at Namazi Hospital in Shiraz, Iran. Forty-four injectable antimicrobial drugs were categorized into antifungals, antibacterials, and antivirals based on their Anatomical, Therapeutic, and Chemical codes.  Changes in prescribing practices were assessed annually based on total consumption rate, per capita consumption, total cost, and per capita cost. Required data were extracted from the hospital pharmacy database. Results:   Following the implementation of HTP, there were increases in total consumption (13.31%), numerical per capita consumption (1.39%), total cost (142.63%), and per capita cost (146%) of injectable antimicrobial drugs. The increases in per capita consumption, total cost, and per capita cost were statistically significant (P <0.05). Conclusion:  In conclusion, changes in antimicrobial consumption patterns following the implementation of HTP may be partially attributed to increased demand facilitated by easier and faster access to requested antibiotics by pharmacists and physicians in hospitals.