Abstract INTRODUCTION This systematic review aimed to assess antibiotic use in Brazilian hospitals in the 21st century, as well as to understand the different drug utilization metrics adopted to assess the consumption of these drugs. METHODS We systematically reviewed five databases (MEDLINE [Medical Literature Analysis and Retrieval System Online], CENTRAL [The Cochrane Central Register of Controlled Trials], EMBASE® [Excerpta Medica Database], Scopus [Elsevier’s abstract and citation database], and LILACS [Literatura Latino-Americana e do Caribe em Ciências da Saúde]) for observational or experimental studies that assessed antibiotic utilization in Brazilian hospitals. The main outcomes were the drug utilization metrics and the consumption of antibiotics. RESULTS We included 23 studies, of which 43.5% were carried out in adult and pediatric care units, 39.1% in adult units, and 17.4% in pediatric units. Regarding the complexity of healthcare, 26.1% of the studies were performed in intensive care units. Two drug utilization metrics were used in these studies: the defined daily dose (DDD) and the percentage of antibiotic prescriptions. The most commonly used antibiotic classes were third-generation cephalosporins, carbapenems, fluoroquinolones, and combinations of penicillins when the DDD was the adopted drug utilization metric. CONCLUSIONS Although few studies have been conducted, existing data indicate a high use of broad-spectrum antibiotics. We found that the lack of standardized antibiotic utilization metrics impaired the mapping of drug consumption at the national level.

Como a energia elétrica é um bem essencial em nossa sociedade, este artigo analisa a evolução da formação e estruturação do setor elétrico brasileiro, desde o surgimento da energia elétrica no Brasil, em 1880, até o final de 2002. A análise se faz a partir da descrição histórica linear, com cortes em fatos determinantes que são detalhados e analisados, mostrando-se os principais atores sociais, seus interesses e influência, na data desses cortes. Foi utilizada a metodologia qualitativa e o referencial da teoria institucional, com base na configuração do campo organizacional, além da análise de documentos e de entrevistas em profundidade, realizadas com dirigentes do setor que participaram dessa história. Finalmente, o artigo mostra como o ambiente externo é o principal elemento que influencia a trajetória do setor elétrico, nomeadamente quanto ao investimento ou não de recursos financeiros.

Considering that electricity is essential to modern society, this article analyzes the formation and organization of the Brazilian electricity sector, from its beginning in this country until the end of 2002. The study is based on a linear description of historical facts, with emphasis on crucial events, which were detailed and analyzed, showing the main social players, their interest and influences in these events. It used qualitative methodology and references by the institutional theory, based on the configuration of the organizational field. It also analyzed documents and carried out semi-structured in-depth interviews with directors who took part of the sector's history. Finally, it shows how the external environment is the main influence on the sector's development, especially on the decision to invest or not in it.