Decenija potrošnje antibakterijskih lekova za sistemsku primenu u Crnoj Gori (2014–2023): trendovi, obrasci i uvidi u AWaRe klasifikaciju
Sažetak
Uvod/Cilj. Antimikrobna rezistencija (AMR) predstavlja sve veću pretnju globalnom zdravlju, sa ozbiljnim posledicama po javno zdravlje i ekonomiju. Praćenje potrošnje antibiotika je od ključne važnosti za razumevanje i rešavanje AMR. Cilj rada bio je da se analiziraju promene u upotrebi antibakterijskih lekova za sistemsku primenu u Crnoj Gori u periodu od 2014. do 2023. godine. Metode. Sprovedena je desetogodišnja retrospektivna studija u kojoj su korišćeni podaci Instituta za lekove i medicinska sredstva Crne Gore, Podgorica, Crna Gora. Antibiotici su klasifikovani prema Anatomsko-terapijsko-hemijskom sistemu Svetske zdravstvene organizacije (SZO), izraženi u definisanim dnevnim dozama na 1 000 stanovnika na dan i kategorizovani prema Access, Watch, Reserve – AWaRe klasifikaciji SZO, kako bi se identifikovali trendovi i obrasci u upotrebi antibiotika. Rezultati. Do 2019. godine uočen je postepeni pad u potrošnji antibiotika, nakon čega je tokom pandemije koronavirusne bolesti 2019 (2020–2021) došlo do naglog porasta i u upotrebi i u troškovima. Iako je nakon pandemije došlo do stabilizacije, potrošnja je ostala viša u odnosu na nivoe pre pandemije. Ukupni trend potrošnje imao je tendenciju smanjenja, ali bez statističke značajnosti (p = 0,291), dok je porast troškova takođe bio statistički neznačajan (p = 0,089). Analiza po podgrupama nije pokazala značajne promene u potrošnji antibiotika iz klasa J01C i J01M. S druge strane, zabeležen je statistički značajan porast u upotrebi antibiotika iz klasa J01D i P01AB (p = 0,001 za obe). Prema AWaRE klasifikaciji, primećeni su značajni pozitivni trendovi u potrošnji antibiotika iz Access (p = 0,022), Watch (p = 0,006) i Reserve (p = 0,026) kategorija. Zaključak. Ovi rezultati ističu važnost sprovođenja kontinuiranih programa upravljanja antibioticima, kao i primene ciljanih intervencija usmerenih ka optimizaciji njihove upotrebe u Crnoj Gori. Takođe, ovi rezultati doprinose globalnim naporima u postizanju smanjenja potrošnje antibiotika.
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