Background and importance A reference panel of antimicrobial consumption indicators was published in 2019 by a committee from the Spanish Society of Hospital Pharmacy (SEFH) and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC).
Aim and objectives To calculate 2020 hospital antimicrobial consumption indicators and carry out a comparative analysis of these consumption indicators with those observed in the previous 2 years.
Material and methods Based on the panel, 10 antimicrobial consumption indicators were selected. The unit of measurement for the consumption was the number of defined daily doses per 100 stays (DDD/100e).
Results Antibacterials overall consumption (OC) 1.5% (86.5 to 85.2) decrease in 2019; and 4.7% increase in 2020 compared to 2019 (89.2).
Antifungals OC 3% decrease in 2019 (7.05 to 6.84); 26% increase in 2020 compared to 2019 (8.65).
Carbapenems: in 2019, consumption decreased by 4.2% (10.17 to 9.74); in 2020 it increased by 2% compared to 2019 (9.94).
Fluoroquinolones: maintained overall 37.4% decrease (13.01 in 2018, 10.83 in 2019 and 8.14 in 2020).
Fosfomycin: maintained overall increase of 27.6% (0.49 in 2018, 0.65 in 2019 and 0.62 in 2020).
Aminoglycosides: maintained overall decrease of 40.7% (3.27 in 2018, 2.32 in 2019 and 1.94 in 2020).
Colistin: 12.8% decrease in 2019 (1.09 to 0.95), and an 8.4% increase in 2020 compared to 2019 (1.03).
Anti-pseudomonal cephalosporins: maintained overall increase of 19% (2.11 in 2018, 2.47 in 2019 and 2.51 in 2020).
Amoxicillin-clavulanate/piperacillin-tazobactam ratio: maintained decrease of 47% compared to 2018 (4.34 in 2018, 3.54 in 2019 and 2.26 in 2020).
Fluconazole/equinocandins ratio: 24% rise in 2019 (4.14 to 5.45); in 2020 it decreased by 16% (4.57).
Conclusion and relevance During 2020, a change in trend has been perceived in a series of antimicrobial consumption indicators, with higher antibacterials and antifungals OC, carbapenems and colistin consumption, and a decreased fluconazole/equinocandins ratio. This change in trend could be related to the increase of multiresistant bacterial and fungal infections associated with COVID-19.
The downward trend in the consumption of fluoroquinolones and aminoglycosides and the upward trend in anti-pseudomonal cephalosporins and fosfomycin was maintained. Interventions carried out through the antimicrobial stewardship programme aimed at optimising and/or de-escalating empirical antimicrobial treatment may be behind this trend.
The amoxicillin-clavulanate/piperacillin-tazobactam ratio may have been influenced by frequent piperacillin-tazobactam stock-outs in the years studied.
References and/or acknowledgements 1. Gutiérrez-Urbón JM.Indicadores del uso hospitalario de antimicrobianos basados en el consumo. Farm Hosp 2019;43(3):94–100.
Conflict of interest No conflict of interest
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