Evaluation of the defined daily dose method for estimating antiinfective use in a university hospital

Abstract

Antiinfective resistance resulting from selection pressure is a generally well-accepted occurrence.1,–5 Many hospitals attempt to limit antiinfective use and misuse by implementing active and passive control measures.6 A variety of methods for tracking antiinfective use patterns are available, such as tracking annual drug expenditures, total units dispensed, and actual patient treatment days or treatment-day estimation using the defined daily dose (DDD) method. Each method has advantages and disadvantages. For example, monitoring drug expenditures is simple but may be misleading because of price changes, inflation, or differences between purchases and actual drug use. Tracking total units dispensed (i.e., drug weight) may also be misleading because of the variety of dose sizes and frequencies associated with each agent. For example, the use of 20 g of both ceftazidime and ceftriaxone would likely not represent a similar number of patient treatment days. Tracking actual treatment days from administration records would be the most accurate method, assuming that all doses are correctly charted, but likely the most difficult due to the extensive manual data extraction required.