What are the advantages and disadvantages of DDDs?
Drug utilisation analysis has used DDDs as the key measure since the 1970s but DDDs were never developed specifically to monitor the impact of antimicrobial stewardship interventions.
So what are the advantages and disadvantages of DDDs as a metric?
|Internationally recognised as assigned and published by WHO.||Unsuitable for child as DDD defined as average dose in adults.|
|Once set by WHO a DDD is not often changed - this allows assessment of prescribing over time.||May underestimate use in patients with renal impairment where dose is adjusted.|
|Easy to produce information on antibiotic use expressed in DDD for ward, unit or hospital.||May overestimate use in patients where higher doses required (CNS infections or obese patients).|
|May not reflect dose of particular infection.|
|Bias against combination therapy - use of three narrow spectrum antibiotics rather than one broad spectrum antibiotic will result in three times as many DDD for the same infection.|
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