{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T04:05:06Z","timestamp":1763179506871,"version":"3.37.3"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100007234","name":"University of Chicago","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007234","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Quantification of antibiotic usage is an important component of antimicrobial stewardship programmes. We aimed to estimate institutional antibiotic usage and costs using methodology and metrics applicable to low-income settings without electronic health records.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The DDD per 100 patient-days (DDDs\/100 PDs) of antibiotics used in a calendar year was calculated retrospectively from ward registers and inpatient drug records in general surgical wards of a tertiary hospital. The antibiotics were categorized using the Access, Watch, Reserve classification. The annual expenditure on antibiotics was estimated from price lists of the state medication procurer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Annual usage of IV co-amoxiclav, cefuroxime and metronidazole was significantly higher than other antibiotics and certain wards showed outlier use of the same. The IV formulations of co-amoxiclav (5-fold), metronidazole (3-fold) and ciprofloxacin (2-fold) were used in excess of the oral formulation. Proportionate antibiotic usage based on the AWaRe category did not vary significantly between wards. Two wards were outliers for annual expenditure\/100 PDs. IV clindamycin and meropenem combined accounted for 43.8% of expenditure on antibiotics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study demonstrated intra-institutional variations of annual antibiotic usage and related costs. The metric DDD\/100 PDs and the methodology used here are suitable for intra- and inter-institutional analyses of antibiotic usage, particularly in low-income settings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkad199","type":"journal-article","created":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T16:39:47Z","timestamp":1687538387000},"page":"2015-2018","source":"Crossref","is-referenced-by-count":2,"title":["A model for analysis of antibiotic usage in low-income settings"],"prefix":"10.1093","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7830-1394","authenticated-orcid":false,"given":"Neesha","family":"Rockwood","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology & Immunology, Faculty of Medicine, University of Colombo , Colombo , Sri Lanka"},{"name":"Department of Infectious Diseases, Imperial College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uma","family":"Mani","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, University of Chicago , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarith","family":"Ranawaka","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Colombo , Colombo , Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sathika","family":"Gunarathna","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Colombo , Colombo , Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6874-6904","authenticated-orcid":false,"given":"Sivasuriya","family":"Sivaganesh","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Colombo , Colombo , Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,6,23]]},"reference":[{"year":"2019","author":"WHO","key":"2023080202251103300_dkad199-B1"},{"key":"2023080202251103300_dkad199-B2","doi-asserted-by":"crossref","first-page":"120","DOI":"10.4103\/0971-5916.164223","article-title":"Systematic review of drug utilization studies & the use of the drug classification system in the WHO-SEARO region","volume":"142","author":"Bachhav","year":"2015","journal-title":"Indian J Med Res"},{"year":"2021","author":"WHO","key":"2023080202251103300_dkad199-B3"},{"key":"2023080202251103300_dkad199-B4","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0257424","article-title":"A national survey of antibacterial consumption in Sri Lanka","volume":"16","author":"Sri Ranganathan","year":"2021","journal-title":"PLoS One"},{"key":"2023080202251103300_dkad199-B5","article-title":"Core prescribing indicators and the most commonly prescribed medicines in a tertiary health care setting in a developing country","volume":"2021","author":"Galappatthy","year":"2021","journal-title":"Adv Pharmacol Pharm Sci"},{"year":"2016","author":"Sri Lanka College of Microbiologists","key":"2023080202251103300_dkad199-B6"},{"key":"2023080202251103300_dkad199-B7","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jgar.2022.05.024","article-title":"Phenotypic and genotypic distribution of ESBL, AmpC \u03b2-lactamase and carbapenemase-producing Enterobacteriaceae in community-acquired and hospital-acquired urinary tract infections in Sri Lanka","volume":"30","author":"Perera","year":"2022","journal-title":"J Glob Antimicrob Resist"},{"key":"2023080202251103300_dkad199-B8","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1186\/s13756-019-0549-8","article-title":"Antimicrobial susceptibility against metronidazole and carbapenem in clinical anaerobic isolates from Pakistan","volume":"8","author":"Shafquat","year":"2019","journal-title":"Antimicrob Resist Infect Control"},{"key":"2023080202251103300_dkad199-B9","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/s40506-019-00188-3","article-title":"Basic, advanced, and novel metrics to guide antibiotic use assessments","volume":"11","author":"Yarrington","year":"2019","journal-title":"Curr Treat Options Infect Dis"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/78\/8\/2015\/50967339\/dkad199.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/78\/8\/2015\/50967339\/dkad199.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T02:25:49Z","timestamp":1690943149000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/78\/8\/2015\/7205836"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,23]]},"references-count":9,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,6,23]]},"published-print":{"date-parts":[[2023,8,2]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkad199","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"type":"print","value":"0305-7453"},{"type":"electronic","value":"1460-2091"}],"subject":[],"published-other":{"date-parts":[[2023,8]]},"published":{"date-parts":[[2023,6,23]]}}}