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The ESAC point prevalence survey: antimicrobial prescribing in 2 age groups of elderly patients from 49 hospitals in 28 European countries in 2008

Abstract number: O469

Amadeo B., Zarb P., Gavazzi G., Muller A., Vankerckhoven V., Davey P., Goossens H.

Objectives: As ageing population raises fast, elderly aged above 65 years are usually considered as a one group in literature. However, if infections are more frequent and more severe in the elderly, they also have specific features related to different subgroups of the elderly patients. This study aimed to identify and to assess the variability of antimicrobial (AM) use between 2 age groups of elderly patients.

Methods: Data were extracted from 49 hospitals of the European Surveillance of Antimicrobial Consumption (ESAC) Point Prevalence Survey carried out during a maximum of 2 weeks from May to June in 28 European countries in 2008. The survey included all inpatients wards and collected information on the treated patients with indications and diagnoses. The analyses were restricted to patients above 65 years which were divided into 2 age year groups (G1: [65–75[; G2: geqslant R: gt-or-equal, slanted75).

Results: Data for treated patients were obtained for 1,579 patients in G1 and 2,132 patients in G2. Among all the treated patients, G2 received less AM combination (G1: 33%; G2: 24%) and parenteral AM (G1: 65%; G2: 57%). The top three AM classes prescribed were similar in both groups and corresponded to combinations of penicillins with b-lactamase inhibitors (G1: 18%; G2: 24%), fluoroquinolones (G1: 12%; G2: 14%) and third-generation cephalosporins (6% for both groups). Infections represented 74% and 83% of all indications in G1 and G2, respectively. Respiratory tract infections were the commonest infections in both groups (G1: 29%; G2: 33%) followed by skin-soft-tissues-and-bone-joint infections in G1 (18%) and urinary tract infections in G2 (23%). The proportion of surgical prophylaxis was lower in the oldest patients (G1: 69%; G2: 66%). The >1 day duration of surgical prophylaxis was 54% in both groups. The prescribed doses for 5 parenteral AM, i.e. benzylpenicillin, gentamicin, cefuroxime, piperacillin–tazobactam, and vancomycin were higher in G1 whilst amoxycillin and cefazolin were higher in G2.

Conclusion: The results of this study showed differences between the 2 elderly age groups, particularly in the proportion of AM combination, parenteral use, and infection site. It became clear that in line with the improved quality of life of the elderly population in industrialized countries, the treatment of G1 is more comparable to that of younger adults. Importantly, future analyses on AM use should take several age groups of the elderly population into consideration.

Session Details

Date: 10/04/2010
Time: 00:00-00:00
Session name: Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Vienna, Austria, 10 - 13 April 2010
Presentation type:
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