Background Bacterial resistance is a major concern in healthcare. It is now recognised that antibiotic consumption is the main reason for resistance. Thus, surveillance tools to measure trends in antibiotic consumption and bacterial resistance are needed.
Purpose The aims of this study were to monitor antibiotic consumption, estimate the cost of this consumption per year, describe the most prescribed classes and the most common indications.
Material and methods We conducted a descriptive, two-year (2015 to 2016) study of antibiotic consumption and prescribing in a new university teaching hospital. The consumption data were extracted from the computerised hospital database. Patient data and antibiotic prescriptions were collected from registered prescriptions at the central Pharmacy Department. We used Anatomical Therapeutic Chemical (ATC) classification. One-year consumption data were collected and expressed as the number of daily defined doses (DDD) per 1000 patient-day.
Results In 2015, overall consumption of antibiotics in the hospital (except for psychiatric patients because of long duration stay) was 256 DDD/1,000 patient-day and 160 DDD/100 admissions, and has increased in 2016 to 365 DDD/1,000 patient-d and 249 DDD/100 admissions (+43%). The cost of antibiotic consumption has risen from €73 490 in 2015 to more than €177,082 2016 and is about 8% of the global cost of purchased medication.
Antibiotic consumption was higher in the Oncology Centre (701 DDD/1000 patient-d), followed by the intensive care unit (624 DDD/1000 patient-d), surgical departments (349 DDD/1000 patient-d), internal medicine (348 DDD/1000 patient-d), paediatric sector (327 DDD/1000 patient-d) and medical departments (232 DDD/1000 patient-d).
Third-generation cephalosporins was the most frequently prescribed class (63%), followed by penicillins (19%), imidazoles (15%), aminosids (11%), quinolons (8%), carbapenems (4%), glycopeptides (4%) and glycylcyclins (1%). Analysis of prescribing active ingredients in 2141 prescriptions has shown that ceftriaxone was prescribed in 60% of cases, followed by metronidazole (15%), amoxicillin associated or not to clavulanic acid (12%), ciprofloxacin (6%) and other ingredients (4%). Urinary tract infections (16%) and respiratory infections (16%) were the most frequent indications for antibiotherapy.
Conclusion Development and implementation of antibiotic stewardship practice are urgently needed to optimise antibiotic prescriptions, decrease antibiotics cost and consumption, and thus bacterial resistance.
References and/or Acknowledgements Acknowledgments to all healthcare professionnals involved in rational antibiotics usage
No conflict of interest