Background CGH is a 560 bed public hospital supporting 150 000 inhabitants. Since 2010, different interventions have been implemented concerning antibiotic distribution (ie, unit dose individual prescription) and initiatives of the hospital’s infections committee (extensive use of antiseptics, staff training, etc).

Purpose The aim of the study was to evaluate antibiotic use in CGH over time, before and after the interventions, in relation to aggregated data from the Public Hospitals of the Country (PHC) in order to improve the hospital medication workflow and patient safety.

Material and methods Prescribed antibiotic data, expressed as DDDs/100 patient days, for the years 2009 to 2014 in CGH, were compared with data from the PHC. Antibiotics were classified according to the ATC system (J01). In addition, the distribution of antimicrobial consumption of antibacterials for systemic use (J01), based on the ECDC methodology, was examined.

Results In 2009, 2013 and 2014, 153.28, 124.03 and 128.36 DDDs/100 patient days, respectively, were used. From 2011 to 2014, the overall use of tetracycline (J01A) and other J01 antibiotics was increased and no significant differences were observed in the average distribution of antimicrobial consumption per category. When comparing these findings with the corresponding distribution in PHC, a remarkably increased rate of the use of tetracyclines in CGH (5%) compared with the use in PHC (2%) was found. Reduced rate of beta-lactam antibiotics in CGH (22%) relative to the use in PHC (28%) was observed. We found a significant increase in DDDs/100 patient days for 2012 and 2014 in the use of colistin (3.96 vs 5.78) and amikacin (1.11 vs 3.44) and a significant decrease in the use of cefuroxime (18.02 vs 10.65) and tazobactam/piperacillin (5.73 vs 4.05).

Conclusion The interventions that took place in CGH led to a gradual decrease in antibiotic use between 2009 and 2014. The high rate of tetracycline use (25% of which related to tigecycline) and increased use of colistin were likely due to the increased numbers of multiresistant strains of Klebsiella pneumonia and Acinetobacter baumanni reported in CGH since the second half of 2011. The reduced rate of beta-lactam antibiotic use was also likely due to resistance problems. Further measures are under investigation to improve antibiotic use in CGH.

No conflict of interest.