Availability of antimicrobials in a university hospital complex in southeastern Brazil

Objective: This study aimed to determine the profile of antimicrobials available in a university hospital complex in southeastern Brazil . Methods: Drug utilization study. Antimicrobials available in clinical practice were identified by researching the Anatomical Therapeutic Chemical (ATC) classification system, The new antimicrobials were identified through research Food and Drug Administration, the European Medicines Agency and the Brazilian National Health Surveillance Agency (ANVISA). The antimicrobials available at the university hospital complex were identified by consulting the hospital drug formulary. Antibacterials were classified according to the WHO AWaRE system. Forgotten antibiotics, defined as old antibiotics, often without patent, used in specific indications that provide treatment for infections of multi-resistant bacteria were identified. Results: A total of 301 antimicrobials for systemic use were identified, 20 antifungals, 43 antivirals and 238 antibacterials, 46.2% registered in Brazil and 19.6% available at the university hospital complex. Among antibacterials, 37 were classified as forgotten antibiotics and 21 as new antibacterials. Regarding the ATC classification the available medications were from the following groups: Antibacterials for systemic use (76.3%), followed by antifungals for systemic use (18.6%) and Antivirals for systemic use (5.1%). According to the WHO AWaRE, 21 of the 45 antibacterials available were in the Access group (46.7%), 17 (37.8%) in the Watch group, and 7 (15.5%) in the Reserve group. Concerning the 21 new antimicrobials agents, seven are registered in Brazil and belongs to the Reserve group of AWaRE classification. Conclusion: The antimicrobials available at the university hospital complex are predominantly antibacterials belonging to the Access group of the AWaRE classification, as well as several forgotten antibiotics. Antibacterials needed to treat infections caused by multidrug-resistant bacteria are also available. antifungals from different therapeutic classes are also available, but the number of antivirals is low. The incorporation of new antimicrobials into the drug formulary of the university hospital complex was reduced.