Ria Benkő

National trend of antidepressant consumption and its impact on suicide rate in Hungary.

The aim of this study was to analyse the changes in the amount and structure of Hungarian antidepressant consumption at national and regional level, furthermore to investigate the possible relationship between antidepressant sales and trends in suicide rates using regional data.

Variations and determinants of antibiotic consumption in Hungarian adult intensive care units.

The aim of this work was to study the use of systemic antibacterials and its possible determinants in Hungarian intensive care units (ICUs).

Evaluation of ambulatory antibiotic use in Hungary using drug-specific quality indicators

INTRODUCTION Rational use of antibiotics is an important tool in combating antibiotic resistance. AIM The aim of the authors was to evaluate the quality of ambulatory antibiotic use in Hungary. METHOD Crude antibiotic sales data for the period between 1996 and 2010 were converted into DDD (Defined Daily Dose) per 1000 inhabitants and per year. The recently developed and validated drug-specific quality indicators were used to evaluate antibiotic use. RESULTS Beside constant quantity (18.0±1.8 DDD/1000 inhabitants/day), the authors detected major changes in the composition of antibiotic use. Ratios of the consumption of broad to narrow spectrum beta-lactams and macrolides increased eight-fold (1996: 2.2 vs. 2010: 15.8) and consumption of fluoroquinolones tripled. Out of the ten surveyed drug-specific quality indicators, Hungary belonged to the European elite in case of three, while considering the remaining seven, Hungary ranked among the weak or weakest European countries. CONCLUSION In quantity Hungary an ambulatory antibiotic use resembles to Scandinavian countries while it mimics antibiotic consumption patterns of southern countries.

Microbiological service for intensive care units in Hungary

For the effective treatment of patients with infectious diseases in intensive care units, reliable microbiological diagnoses and correct evaluations of results by expert infectious disease specialists/microbiologists are indispensable. A 97-question survey was conducted about the antibiotic policy, the available background of the microbiological diagnoses and the consultation possibilities in infectious diseases/microbiology at intensive care units in Hungary. Sixty-two percent (60/96) of questionnaires were returned. Of these units, 55% had a microbiological laboratory in-house. Microbiological reports usually serve as basis for the choice of antibiotic treatment. It is an undesirable practice that during working days and during week-ends the proportions of positive microbiological reports sent back to the wards within the optimal time are only 50% and <20%, respectively. Helpful opinion of an expert infectious disease specialist or microbiologist was available in >90% of the cases during working hours, while out of working hours the help of an infectious disease specialist and a microbiologist specialist was available in 70% and 55% of the cases, respectively. Almost half of the units requested the help of an infectious disease specialist whereas only one-third of them turned to a microbiologist. Accordingly, the background for microbiological laboratory diagnoses available for intensive care units is far from optimal in Hungary and is not adequately stipulated in their working conditions.

Ginger (Zingiber officinale): An alternative for the prevention of postoperative nausea and vomiting. A meta-analysis

BACKGROUND Postoperative nausea and vomiting (PONV) is a distressing outcome related to surgeries. Traditionally, ginger has been used in the treatment of nausea and vomiting for thousands of years. Recently, several randomized, placebo-controlled clinical trials (RCTs) have been conducted to evaluate the efficacy of ginger in PONV. PURPOSE To systematically evaluate the efficacy of ginger on postoperative nausea and vomiting (PONV) compared to placebo, based on RCTs. STUDY DESIGN The meta-analysis was reported following the PRISMA guidelines using the PICO format, and it was registered with the PROSPERO register. METHODS PubMed, Embase, the Cochrane Central Register of Controlled Trials and Web of Science were searched for relevant studies. Human, placebo-controlled clinical studies of patients undergoing any types of surgery, receiving pharmacological doses of ginger per os were included. Only clinical trials with explicit description of the ginger preparation used were analysed. No language or publication year restrictions was applied. RESULTS Ten randomized trials including a total of 918 patients were pooled for the statistical analysis. The present meta-analysis supports that ginger has a significant effect on the severity of PONV based on visual analogue scale (VAS) results: in a fixed effects model the pooled standardized mean difference (SMD) was -0.247 (favouring ginger; [LL]: -0.455, [UL]: -0.040, p-value: 0.019). Moreover, our results suggest that ginger reduces the incidence of postoperative nausea and vomiting, as well antiemetic drug demand; however, these effects are not statistically significant compared to placebo, which may be explained by underdosing. CONCLUSIONS According to our thorough meta-analysis ginger is safe and well tolerated, and decreases the severity of PONV, and may lower the incidence of postoperative nausea and vomiting, which in turn may reduce antiemetic drug demand, suggesting that ginger may be a useful alternative to antiemetic medications to alleviate PONV.

Hazai kórházi antibiotikum-alkalmazás az elmúlt két évtizedben (1996–2015)

Absztrakt Bevezetes: A bakterialis rezisztencia kozegeszsegugyet fenyegető problema, amely mersekelhető, lassithato megfelelő antibiotikum-alkalmazassal. Celkitűzes: A hazai fekvőbeteg-ellatas szisztemas antibiotikum-felhasznalasanak bemutatasa. Modszer: A korhazi antibiotikum-felhasznalasi adatokat az Egeszsegugyi Vilagszervezet anatomiai-terapias-kemiai rendszere szerint osztalyoztak es a Defined Daily Dose metodika szerint kvantifikaltak. A standardizalas korhazi betegforgalmi mutatokra, valamint – a nemzetkozi osszehasonlitas vegett – populaciora tortent. Eredmenyek: A fekvőbetegszektor antibiotikum-felhasznalasa az elmult 20 evben mennyisegileg kiegyenlitett volt (22,4 ± 1,5 DDD/100 apolasi nap), mintazata folyamatos valtozason ment keresztul. Megfigyelhettuk a parenteralis keszitmenyek alkalmazasanak emelkedeset (1996-ban 26,4%, 2015-ben 41,6%). Kiemelendő a felhasznalas osszetetelenek homogenizalodasa az amoxicillin-klavulansav ternyerese miatt, a fluorokinolon (2,3 vs. 4,2 DDD/100 apolasi nap) es ...

Treatment practice of acute cystitis on the basis of national prescription data

INTRODUCTION Urinary tract infections are one of the common diseases in the primary health care. AIM To analyse patterns of ambulatory antibiotic use in acute cystitis. METHOD Antibiotic use data was based on national-level prescription turnovers. Patterns of antibiotic use were evaluated by prescribing quality indicators. The content of different national guidelines for treatment of acute cystitis and adherence to these guidelines were also evaluated. RESULTS For the treatment of acute cystitis quinolones were used predominantly. Norfloxacin (26%) and ciprofloxacin (19%) were prescribed most commonly. The use of internationally recommended agents such as sulphonamides, nitrofurans and fosfomycin shared 15%, 7% and 2%, respectively. The average adherence rate to national guidelines was 66% and certain weak points (e.g. controversial content) of the national guidelines were also identified. CONCLUSIONS Antibiotic use in acute cystitis seems to be suboptimal in Hungary. Considering actual local antibiotic resistance patterns, a new national guideline should be worked out for acute cystitis treatment.

Az akut cystitis kezelésének hazai gyakorlata országos vényforgalmi adatok alapján@@@Treatment practice of acute cystitis on the basis of national prescription data

INTRODUCTION Urinary tract infections are one of the common diseases in the primary health care. AIM To analyse patterns of ambulatory antibiotic use in acute cystitis. METHOD Antibiotic use data was based on national-level prescription turnovers. Patterns of antibiotic use were evaluated by prescribing quality indicators. The content of different national guidelines for treatment of acute cystitis and adherence to these guidelines were also evaluated. RESULTS For the treatment of acute cystitis quinolones were used predominantly. Norfloxacin (26%) and ciprofloxacin (19%) were prescribed most commonly. The use of internationally recommended agents such as sulphonamides, nitrofurans and fosfomycin shared 15%, 7% and 2%, respectively. The average adherence rate to national guidelines was 66% and certain weak points (e.g. controversial content) of the national guidelines were also identified. CONCLUSIONS Antibiotic use in acute cystitis seems to be suboptimal in Hungary. Considering actual local antibiotic resistance patterns, a new national guideline should be worked out for acute cystitis treatment.

Milyen mikrobiológiai laboratóriumi háttér áll rendelkezésre az intenzív betegellátást végző osztályok számára?@@@Microbiological service for intensive care units in Hungary

For the effective treatment of patients with infectious diseases in intensive care units, reliable microbiological diagnoses and correct evaluations of results by expert infectious disease specialists/microbiologists are indispensable. A 97-question survey was conducted about the antibiotic policy, the available background of the microbiological diagnoses and the consultation possibilities in infectious diseases/microbiology at intensive care units in Hungary. Sixty-two percent (60/96) of questionnaires were returned. Of these units, 55% had a microbiological laboratory in-house. Microbiological reports usually serve as basis for the choice of antibiotic treatment. It is an undesirable practice that during working days and during week-ends the proportions of positive microbiological reports sent back to the wards within the optimal time are only 50% and <20%, respectively. Helpful opinion of an expert infectious disease specialist or microbiologist was available in >90% of the cases during working hours, while out of working hours the help of an infectious disease specialist and a microbiologist specialist was available in 70% and 55% of the cases, respectively. Almost half of the units requested the help of an infectious disease specialist whereas only one-third of them turned to a microbiologist. Accordingly, the background for microbiological laboratory diagnoses available for intensive care units is far from optimal in Hungary and is not adequately stipulated in their working conditions.