Prevalence of antibiotic use in hospitals inCyprus

Abstract number: P757

Kritsotakis E., Vounou E., Kontou M., Papakyriakou P., Koliou-Mazeri M., Dimitriadis I., Gikas A.

Objectives: There are few data on antibiotic prescribing within Cypriot hospitals. This study, set out as part of a larger study of nosocomial infections, aimed to obtain main indicators of hospital antibiotic use in Cyprus.

Methods: A point prevalence survey was conducted in the 5 public hospitals of Cyprus in November 2006. The survey included all inpatients older than 1 year who, on the study day, had been present for at least 24 hours in the hospital. Data collected for all patients included demographics, antibiotics for systemic use received on the survey day and duration of prescription.

Results: On the survey day, 345 out of the 705 screened patients (48.9%) were receiving antibiotics (interhospital range: 38.8–53.3%), of whom 115 patients (33.3%) were receiving combination therapy. The highest prevalence of antibiotic use was observed in surgical wards (59.9%), followed by paediatric wards (54.2%), intensive care units (50%), medical wards (42.8%), and gynaecology-obstetrics wards (20.6%). A total of 176 patients (51.0%) received empirical treatment; 119 patients (34.5%) received surgical prophylaxis, and 30 patients (8.7%) received antibiotics for bacteriologically documented infection. For 20 patients (5.8%), no justification for antibiotic use was provided. Of the patients who received perioperative prophylaxis, 82 patients (68.9%) had undergone surgical operations classified as "clean". The median duration of perioperative prophylaxis was 3 days (interhospital range: 2.0–3.5 days). Out of the total 468 antibiotics prescribed, the most commonly used classes included third generation cephalosporins (23.5%), second generation cephalosporins (17.9%), imidazoles (11.5%), fluoroquinolones (10.3%), carbapenems (8.1%), macrolides (5.3%), and glycopeptides (5.1%).

Conclusion: A high prevalence of hospital antibiotic use was found in Cyprus, compared to the prevalence seen in other European countries. The frequent use of combination therapy and broad spectrum antibiotics, their use in clean surgery and the extended duration of surgical prophylaxis observed in this study, are indicative of the potential for limiting and improving prescribing. Study data emphasize the need to develop effective antibiotic surveillance and management programmes in Cypriot hospitals.