[Impact of Integrated Model for Rational Use of Antibiotics in a health area (project MIURA)].

Background: MIURA (Integrated Model for the Rational Use of Antimicrobials) is a project that began in January 2004 and ended in December 2006. Through quarterly and training interventions intented for physicians, pharmacists and patients, pretends to improve antibiotic use in a health area. The goal was to analyze the evolution of antibiotic consumption and assess the impact of implementing this project in a health area.

Method: A comparative study on the evolution of antibiotic dispensed during the periods 2000-03 (pre-MIURA), 2004-06 (MIURA) and 2007-08 (post-MIURA) in the Department of Health 11 of Valencia was conduced. Antibiotics information was obtained through the GAIA application (Generalitat Valenciana) that collects information about the drugs billed by the pharmacy through the official prescriptions. Technical unit of measurement was used DHD (daily dose defined/1.000 inhabitants/day).

Results: During the implementation of the project (2004-2006), antibiotic consumption was reduced in 4.02 DHD. It represents a statistically significant overall reduction from 15% (p= <0.05). Since interventions started, a statistically significant decrease in DHD values was observed for macrolides (especially clarithromycin) and cephalosporines. It also exist an average decrease, not significant, for the group of quinolones, whereas penicillins and other antibiotics haven't showed variability in the consumption data. In the post-MIURA period was detected a further increase in the dispensing of antibiotics.

Conclusions: MIURA program has positively influenced on decreasing antibiotic prescription in our health area, as shows the decrease in DHD during the interventions.