Retrospective surveillance of antibiotic use in maternitywards and neonatal intensive care units in Saint Petersburg, Russia

AbstractAntibiotic overuse in infants is associated with an increased risk of serious adverse events. Development of antibiotic stewardshipprograms aimed at reducing overall antibiotic consumption requires epidemiological surveillance. Retrospective surveillance andevaluation of all antibiotics provided to every infant admitted to maternal wards or neonatal intensive care units (NICUs) from 01January 2014 to 31 December 2014 were performed in five medical centers of Saint Petersburg, Russia. Types of antibiotics anddates of administration were recorded. Antibiotic use was quantified by length of therapy (length of therapy, LOT, per 1000patient-days, PD) and days of therapy (DOT/1000 PD). An additional parameter named Binstant DOT/1000 PD^ was introducedby authors for assessment of longitudinal patterns of administrations. Antibiotic load was 825.6 DOT/1000 PD in maternitywards and 1425.8 DOT/1000 PD in the NICUs. These levels are two to four times higher than DOTs reported in the USA for alevel III NICU (348DOT/1000PD). Antibiotic loadwas associatedwith the length of hospital stay (LOS) and birth weight. Theseassociations were distorted when assessed using the conventional parameters, LOT and DOT, because they do not reflect thelongitudinal component of treatment and underestimate antibiotic load when a patient stays in hospital without treatment. Theproposed additional parameter successfully overcame these flaws and uncovered hidden associations. Severe overuse of antibioticsmay be taking place in Russia and antibiotic stewardship development should be urged. Instant DOT/1000 PD is a morepowerful tool in assessing treatment patterns than DOT/1000 PD.Keywords Antibiotic . Neonate . Stewardship . Days of treatmen

Psychological features of abstinent heroin users before and after rehabilitation in Saint Petersburg, Russia

Abstract Objective The objective of the study was to describe psychological features of abstinent heroin users undergoing rehabilitation in Saint Petersburg, Russia. Study subjects (n = 197) were recruited prospectively at the time of their admission to rehabilitation between March 2010 and May 2011 at 7 inpatient opiate addiction rehabilitation centers in Saint-Petersburg and neighboring regions, Russia. The centers provided varying rehabilitation programs; 6 of them were religious centers. Socio-demographic information and self-reported HIV status were collected. Personality profiles and severity of drug-associated problems were estimated before and after rehabilitation using the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and the Addiction Severity Index (ASI). Results Thirty-three (17%) subjects dropped out before completing rehabilitation (non-completers). All subjects (completers and non-completers) had psychopathological personality profiles according to MMPI-2. These profiles were refractory to clinically significant improvement after rehabilitation, although some statistically significant changes toward improvement were observed. ASI scores showed statistically and clinically significant improvements after rehabilitation on all scales. Participants in longer-term versus shorter-term rehabilitation programs showed similar changes in their pre- and post-rehabilitation MMPI-2 and ASI scores. Our results suggest that unmet psychiatric needs should be addressed to potentially improve treatment completion in this population