Surveillance of antibiotic consumption in 861 French hospitals: lessons from a nationwide network, 2008
Abstract number: P1495
Dumartin C., L'Heriteau F., Pefau M., Angora P., Bertrand X., Boussat S., Jarno P., Lacave L., Nguyen F., Saby K., Savey A., Alfandari S., Coignard B., Schlemmer B., Touratier S., Carbonne A., Rogues A.M.
Objectives: To improve antibiotic (AB) use, French hospitals are required to implement AB stewardship programmes including surveillance of AB consumption. A survey was performed by the regional centres for healthcare associated infections prevention and control, under the auspices of the French RAISIN-network, to describe AB consumption at hospital and ward level and provide tools for benchmarking.
Methods: Antibacterials for systemic use (J01 class of the WHO Anatomical Therapeutic Chemical classification (ATC)-Defined daily doses (DDD) system, 2008) were surveyed. Rifampin and oral imidazole derivatives were also included to better assess total AB exposure. AB consumption for inpatients, expressed in number of DDD per 1,000 patient-days (PD), and number of PD in 2008 were retrospectively collected by 861 voluntary hospitals: 35 teaching hospitals, 503 non-teaching hospitals, 11 cancer centres, 157 rehabilitation centres, 72 local hospitals, 83 long-term care (LTC) and psychiatric hospitals. They accounted for 42% of French hospitals beds and for about 58 million PD.
Results: AB use (pooled mean) was 370 DDD/1,000 PD. The most frequently used antibiotics were: amoxicillinclavulanic acid (32% of total number of DDD), amoxicillin (17%) and ofloxacin (5.5%). Median consumption ranged from 56 DDD/1,000 PD in LTC and psychiatric hospitals to 610 in teaching hospitals, with wide variations among hospitals belonging to the same group. Median consumption differed according to hospital clinical wards: 59 in psychiatric wards, 71 in LTC wards, 199 in rehabilitation, 316 in gynaecology, 332 in paediatrics, 570 in surgery and medicine, 1,465 in intensive care units. Among similar wards, variations were seen in both AB volume and distribution.
Conclusion: AB use in French acute care hospitals did not seem higher than that reported in other European countries, when expressed in DDD/1,000 PD. This multicentre survey provided detailed information on AB use in a large sample of hospitals and wards. Its findings underscore 1) the relevance of data collection at ward level to foster consumption analysis and target AB use practice audits; 2) the usefulness of a nation-wide surveillance network, allowing relevant comparisons and benchmarking through sharing of experiences. Data from this network, together with information from practices audits, will enable to monitor trends in AB use in hospitals and to assess the impact of AB stewardship programmes.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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