Background: The aim of this study was to compare Hungarian antibiotic use in acute cystitis with the internationally developed disease-specific quality indicators and with the national guidelines. Methods: The aggregated national-level data on systemic antibiotic use was purchased from the National Health Fund Administration. The study period was January–June 2007. Antibiotic use in acute cystitis was evaluated by means of the defined daily dose (DDD) methodology. Quality indicators of antibiotic prescribing proposed by the European Surveillance of Antimicrobial Consumption (ESAC) team were the usage rate of recommended antibacterials and the usage rate of quinolones. Adherence to the available national guidelines was determined. Results: For acute cystitis, 1.06 DDD per 1000 inhabitant-days antibiotic use was recorded. The ESAC recommended antibiotic use in cystitis (23.3%) was well below the recommended range (80–100%). The consumption of fluoroquinolones was 56.2%, which exceeded the recommended range (0–5%) more than 10 times. The adherence rate to the Hungarian guidelines ranged between 59.3% and 74.2%. Conclusions: As both investigated disease-specific quality indicators were well outside the acceptable ranges, some inappropriateness of antibiotic use in cystitis seems to be present. Adherence rates to the different national guidelines were also moderate, but due to the general recommendation of quinolones, values should be interpreted with caution. New transparent guidelines – issued by the Hungarian Society of Family Physicians – should be introduced in Hungary, recommending quinolones only for second-line therapy.

Rational use of antibiotics is an important tool in combating antibiotic resistance. The aim of the authors was to evaluate the quality of ambulatory antibiotic use in Hungary. Crude antibiotic sales data for the period between 1996 and 2010 were converted into DDD (Defined Daily Dose) per 1000 inhabitants and per year. The recently developed and validated drug-specific quality indicators were used to evaluate antibiotic use. Beside constant quantity (18.0±1.8 DDD/1000 inhabitants/day), the authors detected major changes in the composition of antibiotic use. Ratios of the consumption of broad to narrow spectrum beta-lactams and macrolides increased eight-fold (1996: 2.2 vs. 2010: 15.8) and consumption of fluoroquinolones tripled. Out of the ten surveyed drug-specific quality indicators, Hungary belonged to the European elite in case of three, while considering the remaining seven, Hungary ranked among the weak or weakest European countries. In quantity Hungary an ambulatory antibiotic use resembles to Scandinavian countries while it mimics antibiotic consumption patterns of southern countries.

Annually, 172 million fall events cause temporary or permanent impairment in older adults, and this number is increasing. Contributing factors that increase the risk for falls include age, polypharmacy, and malnutrition. This study evaluated medications mainly included in the EU(7)-PIM (potentially inappropriate medication) list. From March 21, 2022, to July 6, 2022, 945 patients who experienced a fall and visited the Department of Emergency Medicine at the Albert Szent-Györgyi Health Centre of the University of Szeged in Hungary. Data from 886 patients were collected (study group). The control group included 1364 patient data collected from three general practice in Hungary. The use of ≥ 2 EU(7)-PIM drugs was found to be associated with increased risk for falls (adjusted odds ratio [AOR], 1.38; 95% confidence interval [CI] 1.01–1.88). Piracetam (AOR, 1.81; 95% CI, 1.28–2.57) and trimetazidine (AOR, 1.62; 95% CI, 1.17–2.24) were associated with increased risk for falls. Doxazosin was associated with a low risk for falls (AOR, 0.59; 95% CI, 0.41–0.86). Tiapride (AOR, 3.54; 95% CI, 1.75–7.17), gliclazide (AOR, 1.57; 95% CI, 1.02–2.43), and vinpocetine (AOR, 1.95; 95% CI, 1.29–2.95) are not included in the EU(7)-PIM list; however, they are associated with increased risk for falls. Long-acting benzodiazepines (AOR, 1.79; 95% CI, 1.20–2.68), antidepressants (AOR, 1.89; 95% 95% CI, 1.37–2.61), serotonin–norepinephrine reuptake inhibitor (AOR, 2.82; 95% CI, 1.41–5.67; p < 0.01), and selective serotonin reuptake inhibitor (AOR, 1.88; 95% CI, 1.24–2.85) were also associated with increased risk for falls. However, Z-drugs were associated with a low risk for falls (AOR, 0.57; 95% CI, 0.36–0.92). With the help of this tool, trimetazidine and piracetam are filtered as EU(7)-PIM drugs associated with increased risk for falls.